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Individual

DR. LESLIE A VENSEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
40 2ND AVE, SUITE 400, WALTHAM, MA 02451-1132
(781) 487-4350
(781) 487-4351
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(781) 487-4350
(781) 487-4351

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
57348
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3054799
MA
01
713954
TUFTS HEALTH PLAN
MA
01
J09081
BCBS MA
MA
Enumeration date
10/25/2005
Last updated
06/03/2014
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