Healthcare Provider Details

I. General information

NPI: 1407147093
Provider Name (Legal Business Name): LEAH AILED ORTA NIEVES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 09/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW DEPARTMENT OF OBSTETRICS AND GYNECOLOGY
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

110 IRVING ST NW DEPARTMENT OF OBSTETRICS AND GYNECOLOGY
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8531
  • Fax: 877-544-7752
Mailing address:
  • Phone: 202-877-8035
  • Fax: 202-877-5435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD043468
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: