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Individual
THERESA MARIE LEAK-GONZALEZ
Active
Individual
THERESA MARIE LEAK-GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
235395
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0045415
NEIGHBORHOOD HEALTH PLAN
MA
01
—
04-55814
EVERCARE
MA
01
—
0844040
CIGNA
—
05
—
110079874A
—
MA
01
—
1679587265
PHCS
MA
01
—
1679587265
ANTHEM
NH
05
—
30207840
—
NH
01
—
497486
TUFTS
MA
01
—
95347501
NETWORK HEALTH
MA
01
—
AA120030
HPHC
MA
01
—
J43036
BCBS
MA
01
—
P00983236
RR MEDICARE
MA
Enumeration date
07/28/2006
Last updated
11/16/2012
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