Individual
TRACY A LIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
228 BILLERICA RD, CHELMSFORD, MA 01824-3604
(978) 250-6300
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
158947
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022340
NEIGHBORHOOD HEALTH
MA
05
—
0137201
—
MA
01
—
158947
TUFTS
MA
01
—
J19972
BLUE CROSS
MA
01
—
PP901
HARVARD PILGRIM
MA
Enumeration date
01/12/2006
Last updated
12/13/2021
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