Provider Demographics
NPI:1922000249
Name:LESSING, MARK ELLIOT (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ELLIOT
Last Name:LESSING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MANOR DR
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1057
Mailing Address - Country:US
Mailing Address - Phone:781-749-6055
Mailing Address - Fax:781-556-0028
Practice Address - Street 1:5 MANOR DR
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1057
Practice Address - Country:US
Practice Address - Phone:781-749-6055
Practice Address - Fax:781-556-0028
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1435213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY70574Medicare ID - Type UnspecifiedBLUE SHIELD/MEDICARE
MAT58664Medicare UPIN
MAY70574Medicare PIN