Individual
LESLIE JEAN DOMALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 LAKE AVE N, ACC BUILDING, WORCESTER, MA 01655-0002
(508) 334-3206
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
246161
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010039502CT01
ANTHEM BCBS
—
01
—
1219546
UNITED HEALTHCARE
—
01
—
1233211
CIGNA HEALTHCARE
—
01
—
139502
CONNECTICARE
—
01
—
2V2568
HEALTHNET
—
01
—
P2839358
OXFORD
—
Enumeration date
08/23/2006
Last updated
12/11/2023
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