Provider Demographics
NPI:1861469785
Name:LEAVITT, JEFFREY I (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:I
Last Name:LEAVITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:300 MOUNT AUBURN ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5600
Mailing Address - Country:US
Mailing Address - Phone:617-497-1560
Mailing Address - Fax:617-497-1109
Practice Address - Street 1:300 MOUNT AUBURN ST
Practice Address - Street 2:SUITE 310
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5600
Practice Address - Country:US
Practice Address - Phone:617-497-1560
Practice Address - Fax:617-497-1109
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2011-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA60344207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ25105OtherBCBS
MA0190942Medicaid
MA060344OtherTUFTS
MA1861469785OtherBOSTON MEDICAL CENTER HEALTH NET PLAN
MA2901140OtherAETNA HEALTH PLAN
MA0018444OtherNEIGHBORHOOD HEALTH PLAN
MA59300OtherFALLON HEALTH PLAN
MA2295706OtherCIGNA HEALTH PLAN
MA304187OtherHARVARD PILGRIM HEALTH PLAN
MA97526602OtherNETWORK HEALTH PLAN
MA304187OtherHARVARD PILGRIM HEALTH PLAN