Healthcare Provider Details

I. General information

NPI: 1689835316
Provider Name (Legal Business Name): THOMAS H. LESNIK, MD,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 LAFAYETTE ST
NORWICH CT
06360-2708
US

IV. Provider business mailing address

119 LAFAYETTE ST
NORWICH CT
06360-2708
US

V. Phone/Fax

Practice location:
  • Phone: 860-886-1947
  • Fax: 860-823-1644
Mailing address:
  • Phone: 860-886-1947
  • Fax: 860-823-1644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number016431
License Number StateCT

VIII. Authorized Official

Name: DR. THOMAS HENRY LESNIK
Title or Position: PRESIDENT
Credential: M.D.
Phone: 860-886-1947