Healthcare Provider Details

I. General information

NPI: 1669657227
Provider Name (Legal Business Name): LESLIE DUSTIN ROKOSKE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 WISCONSIN AVE NW SUITE 400 THE ROSS CENTER
WASHINGTON DC
20015
US

IV. Provider business mailing address

5225 WISCONSIN AVE NW SUITE 400 THE ROSS CENTER
WASHINGTON DC
20015
US

V. Phone/Fax

Practice location:
  • Phone: 202-363-1010
  • Fax: 202-363-2383
Mailing address:
  • Phone: 202-363-1010
  • Fax: 202-363-2383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD036454
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: