Provider Demographics
NPI:1740371038
Name:LENDER, NATALIE LEONID (MD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:LEONID
Last Name:LENDER
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:124 WATERTOWN ST
Mailing Address - Street 2:SUITE 2 D
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-2576
Mailing Address - Country:US
Mailing Address - Phone:617-916-5069
Mailing Address - Fax:617-467-4073
Practice Address - Street 1:124 WATERTOWN ST
Practice Address - Street 2:SUITE 2 D
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2576
Practice Address - Country:US
Practice Address - Phone:617-916-5069
Practice Address - Fax:617-467-4073
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1528592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3173615Medicaid
MA3173615Medicaid