1003184482 NPI number — DR. ELLEN WERBER LESCHEK M.D.

Table of content: DR. ELLEN WERBER LESCHEK M.D. (NPI 1003184482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003184482 NPI number — DR. ELLEN WERBER LESCHEK M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LESCHEK
Provider First Name:
ELLEN
Provider Middle Name:
WERBER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WERBER
Provider Other First Name:
ELLEN
Provider Other Middle Name:
DARYL
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1003184482
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6707 DEMOCRACY BOULEVARD, ROOM 603
Provider Second Line Business Mailing Address:
NATIONAL INSTITUTES OF HEALTH/NATIONAL INSTITUTE OF DIA
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20892
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-402-8291
Provider Business Mailing Address Fax Number:
301-480-3503

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9000 ROCKVILLE PIKE
Provider Second Line Business Practice Location Address:
NATIONAL INSTITUTES OF HEALTH - CLINICAL CENTER, PEDIAT
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20892
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-451-9229
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/13/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080P0205X , with the licence number:  D0047866 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)