Individual
GIANNOULA LAKKA KLEMENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 WASHINGTON ST, FLOATING HOSPITAL FOR CHILDREN AT TUFTS MEDICAL CENTER, BOSTON, MA 02111-1552
(617) 636-5535
(617) 636-7738
Mailing address
45 HEMENWAY ST, UNIT 1, BOSTON, MA 02115
(617) 536-0515
(617) 562-7142
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
219313
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2025990
MASSHEALTH (MA MEDICAID)
—
01
—
219313
TUFTS
—
01
—
4460262
CIGNA
—
01
—
80300
FALLON COMMUNITY HEALTH P
—
01
—
AA11828
HPHC (DFCI ONLY)
—
01
—
J26938
BCBS OF MA, INDEMNITY, BC
—
Enumeration date
05/25/2006
Last updated
09/01/2009
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