Provider Demographics
NPI:1780673558
Name:TROY, LEO JOSEPH JR (MD)
Entity Type:Individual
Prefix:
First Name:LEO
Middle Name:JOSEPH
Last Name:TROY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:20 GUEST ST STE 225
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2065
Mailing Address - Country:US
Mailing Address - Phone:617-491-6766
Mailing Address - Fax:617-491-2552
Practice Address - Street 1:300 MOUNT AUBURN ST
Practice Address - Street 2:STE 505
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5600
Practice Address - Country:US
Practice Address - Phone:617-491-6766
Practice Address - Fax:617-491-2552
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2017-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA59881207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3046435Medicaid
MA3046435Medicaid
MA1780673558Medicare NSC