Provider Demographics
NPI:1063619260
Name:LEEMAN, HOLLY MICHELE (MD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:MICHELE
Last Name:LEEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:MICHELE
Other - Last Name:BALESTRIERI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:125 BIRDS HILL AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-4240
Mailing Address - Country:US
Mailing Address - Phone:781-708-6279
Mailing Address - Fax:
Practice Address - Street 1:90 LIBBEY PARKWAY
Practice Address - Street 2:SUITE 105
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189
Practice Address - Country:US
Practice Address - Phone:339-201-4120
Practice Address - Fax:339-201-4122
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA252569207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110094185AMedicaid
MA002916401Medicare PIN