Provider Demographics
NPI:1992754857
Name:NORTHEAST CARDIOLOGY, INC.
Entity type:Organization
Organization Name:NORTHEAST CARDIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEFKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-586-3900
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-0071
Mailing Address - Country:US
Mailing Address - Phone:978-657-5866
Mailing Address - Fax:978-657-5877
Practice Address - Street 1:496 LYNNFIELD ST
Practice Address - Street 2:SUITE 104
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-1423
Practice Address - Country:US
Practice Address - Phone:781-586-9300
Practice Address - Fax:781-536-8430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80275207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA036361OtherTUFTS INDIVIDUAL NUMBER
MA9701800Medicaid
MAD14255OtherINDIVIDUAL BS NUMBER
MAM16617OtherGROUP BS NUMBER
MA613569OtherTUFTS GROUP
MA989687OtherNETWORK HEALTH
MA0189316Medicaid
MA300303OtherHARVARD PILGRIM
MAA54152Medicare UPIN
MA613569OtherTUFTS GROUP