Healthcare Provider Details

I. General information

NPI: 1336198282
Provider Name (Legal Business Name): LEONARD WARTOFSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW #2A38
WASHINGTON DC
20010-2976
US

IV. Provider business mailing address

110 IRVING ST NW #2A38
WASHINGTON DC
20010-2976
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-2848
  • Fax: 202-877-6292
Mailing address:
  • Phone: 202-877-2848
  • Fax: 202-877-6292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD4979
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: