Individual
LEANNA JEAN TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
725 ALBANY ST STE 7A, BOSTON, MA 02118-3549
(617) 414-4639
Mailing address
960 MASSACHUSETTS AVE STE 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
1025956
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
293206
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110190523A
—
MA
Enumeration date
03/30/2022
Last updated
06/04/2026
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