Provider Demographics
NPI:1932188414
Name:LEE, LAURA Z (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:Z
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:ZACCARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:228 BILLERICA RD
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-3604
Mailing Address - Country:US
Mailing Address - Phone:978-250-6300
Mailing Address - Fax:978-250-6335
Practice Address - Street 1:228 BILLERICA RD
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3604
Practice Address - Country:US
Practice Address - Phone:978-250-6300
Practice Address - Fax:978-250-6335
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA159008208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3208532Medicaid
MA0021599OtherNEIGHBORHOOD HEALTH
MA159008OtherTUFTS
MAJ22153OtherBLUE CROSS
MAPP043OtherHARVARD PILGRIM
MAA32137Medicare ID - Type Unspecified
MA3208532Medicaid