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NPI Code Detail

MEDICARE: DR. GREGORY THOMAS LESNIK M.D.

MEDICARE: DR. GREGORY THOMAS LESNIK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1710157805
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY THOMAS LESNIK M.D.
Provider Business Mailing Address
First Line : 119 LAFAYETTE ST
Second Line :
City : NORWICH
State : CT
Zip : 06360-2708
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 119 LAFAYETTE ST
Second Line :
City : NORWICH
State : CT
Zip : 06360-2708
Country : US
Telephone Number : 860-886-1947
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2008
Last Update Date : 03/05/2008

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