Provider Demographics
NPI:1366432056
Name:CHAMBERLAIN-LANDIS, ELIZABETH R (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:R
Last Name:CHAMBERLAIN-LANDIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:5 WATER ST
Practice Address - Street 2:ARLINGTON PEDIATRICS ASSOC PC
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476
Practice Address - Country:US
Practice Address - Phone:781-641-5800
Practice Address - Fax:339-707-6028
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA81123208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3139433Medicaid
MA081123OtherTUFTS HEALTH PLAN
MAJ31297OtherBCBS MA
G03969Medicare UPIN
MAJ31297Medicare ID - Type Unspecified