1508898867 NPI number — NEIL LESITSKY MD

Table of content: NEIL LESITSKY MD (NPI 1508898867)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508898867 NPI number — NEIL LESITSKY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LESITSKY
Provider First Name:
NEIL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508898867
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 783311
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19178-3311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-884-4500
Provider Business Mailing Address Fax Number:
484-884-0699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2588 STATE ROUTE 903
Provider Second Line Business Practice Location Address:
STE 2
Provider Business Practice Location Address City Name:
ALBRIGHTSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-722-2125
Provider Business Practice Location Address Fax Number:
570-722-2127
Provider Enumeration Date:
07/07/2006

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: 207Q00000X , with the licence number:  MD038870E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 70233 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 545141 . This is a "BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 40261 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5900102 . This is a "GHI NEW YORK INS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 569210 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 700001986 . This is a "RR MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0012165430001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2694337 . This is a "OXFORD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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