Provider Demographics
NPI:1841246964
Name:DULASKI, KRISTINE LESCINKSAS (MD)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:LESCINKSAS
Last Name:DULASKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 YORK RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-1760
Mailing Address - Country:US
Mailing Address - Phone:617-947-5158
Mailing Address - Fax:
Practice Address - Street 1:148 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2505
Practice Address - Country:US
Practice Address - Phone:781-453-3777
Practice Address - Fax:617-754-8632
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220317207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA36647OtherLEGACY
MA2041171Medicaid
MAA36647OtherMEDICARE LEGACY
I04299Medicare UPIN