Healthcare Provider Details

I. General information

NPI: 1659370641
Provider Name (Legal Business Name): LEE EDWARD FIRESTONE D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 05/26/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 K ST NW STE 580
WASHINGTON DC
20006-1529
US

IV. Provider business mailing address

PO BOX 825159
PHILADELPHIA PA
19182-5159
US

V. Phone/Fax

Practice location:
  • Phone: 202-223-4616
  • Fax: 202-223-0740
Mailing address:
  • Phone: 202-331-9727
  • Fax: 202-887-0741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1204
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberP0546
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: