Basic Information
| Provider Information | |||||||||
| NPI: | 1003832635 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUBINSKY | ||||||||
| FirstName: | LESLIE | ||||||||
| MiddleName: | A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 WRIGHT ST | ||||||||
| Address2: | |||||||||
| City: | PALMER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4132837651 | ||||||||
| FaxNumber: | 4132845117 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 WRIGHT ST | ||||||||
| Address2: | |||||||||
| City: | PALMER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4132845276 | ||||||||
| FaxNumber: | 4132845117 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 02/11/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 212524 | MA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | P00096537 | 01 | RR MEDICARE | OTHER | 976852 | 01 | NETWORK HEALTH | OTHER | 212524 | 01 | CONNECTICARE | OTHER | 2128263001 | 01 | CIGNA | OTHER | J24768 | 01 | BLUE CROSS BLUE SHIELD | OTHER | 3547845 | 01 | HEALTHSOURCE CMHC | OTHER | 0173908 | 05 | MA | MEDICAID | 212524 | 01 | TUFTS COMMUNITY HEALTH PL | OTHER |