Provider Demographics
NPI:1427085315
Name:SILLIN, LELAN F (MD)
Entity type:Individual
Prefix:
First Name:LELAN
Middle Name:F
Last Name:SILLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:LAHEY CLINIC PROVIDER ENROLLMENT
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8923
Mailing Address - Fax:781-744-5215
Practice Address - Street 1:41 MALL RD
Practice Address - Street 2:LAHEY CLINIC DEPARTMENT OF GENERAL SURGERY
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-8831
Practice Address - Fax:781-744-5636
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144421208C00000X, 208600000X
MA235646208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00577371Medicaid
G01458Medicare UPIN
NY00577371Medicaid