Basic Information
Provider Information
NPI: 1598076465
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZHAO
FirstName: LEI
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 75 FRANCIS ST
Address2:  
City: BOSTON
State: MA
PostalCode: 021156110
CountryCode: US
TelephoneNumber: 6177327510
FaxNumber:  
Practice Location
Address1: 75 FRANCIS ST
Address2:  
City: BOSTON
State: MA
PostalCode: 021151447
CountryCode: US
TelephoneNumber: 6177327510
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/25/2010
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102X125.057995ILN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZP0102X272478MAY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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