Individual
THOMAS A. LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
26 CITY HALL MALL, MEDFORD, MA 02155-4754
(781) 306-5184
(781) 306-5303
Mailing address
26 CITY HALL MALL, MEDFORD, MA 02155-4754
(781) 306-5184
(781) 306-5303
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3638
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014551
NEIGHBORHOOD HEALTH
MD
01
—
003638
TUFTS HEALTH PLAN
MD
05
—
0312860
—
MA
01
—
4317868-002
HEALTHSOURCE
MA
01
—
E263
HARVARD PILGRIM
MA
01
—
W16047
BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/23/2006
Last updated
02/19/2021
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