Daniel Elazar Leisman
Student in an Organized Health Care Education/Training Program in Boston, MA. Individual provider (NPI-1).
NPI number1164050852
StatusActive
Last updated in NPPESJun 21, 2024
Details
- NPI
- 1164050852
- Entity type
- Individual (NPI-1)
- Name
- Daniel Elazar Leisman
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 30, 2020
- Certification date
- Jun 21, 2024
- Last updated
- Jun 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
55 Fruit StBoston, MA 02114-2621
Phone 617-726-2000
Mailing address
55 Fruit St # 7-730Boston, MA 02114-2696
Phone 516-941-8468
Other practice locations
330 Brookline Ave # Shapiro7
Boston, MA 02215-5491
Boston, MA 02215-5491
Phone 617-667-5864
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