| Elizabeth Prusak, MD | |
| 41 Mall Rd, Burlington, MA 01805-0001 | |
| (781) 744-5100 | |
| Not Available | 
| Full Name | Elizabeth Prusak | 
|---|---|
| Gender | Female | 
| Speciality | Obstetrics & Gynecology | 
| Location | 41 Mall Rd, Burlington, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1255514386 | NPI | - | NPPES | 
| 110086089A | Medicaid | MA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 01083083A (Indiana) | Primary | 
| 207VG0400X | Obstetrics & Gynecology - Gynecology | 242943 (Massachusetts) | Secondary | 
| Entity Name | Midwest Dysphagia Consultants Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1639404171 PECOS PAC ID: 8820360795 Enrollment ID: O20170828002434 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Elizabeth Prusak, MD 3403 E Raymond St, Indianapolis, IN 46203-4744 Ph: (317) 957-2000 | Elizabeth Prusak, MD 41 Mall Rd, Burlington, MA 01805-0001 Ph: (781) 744-5100 | 
| Temitope Patricia Awosogba, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 41 Mall Road, Burlington, MA 01805 Phone: 781-744-8560 Fax: 781-744-5398 | |
| Marc F Freedman, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 101 Cambridge St, Burlington, MA 01803 Phone: 781-272-4667 | |
| Dr. Anju T Nayar, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 101 Cambridge St, Burlington, MA 01803 Phone: 781-272-4667 Fax: 781-270-4196 | |
| Sarah Bennett, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 101 Cambridge St Ste 160, Burlington, MA 01803 Phone: 781-672-4667 | |
| Nidha P. Mattappally, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: Lahey Hospital And Medical Center, 41 Mall Road, Burlington, MA 01805 Phone: 781-744-8560 Fax: 781-744-5398 | |
| Shilpa Malhotra, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 20 Wall St, Burlington, MA 01803 Phone: 781-221-2940 | |
| Valena J Wright, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: Lahey Clinic, 41 Mall Rd., Burlington, MA 01805 Phone: 781-744-8000 Fax: 781-744-5349 |