Healthcare Provider Details

I. General information

NPI: 1225565500
Provider Name (Legal Business Name): CENTER FOR LASER SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 NEW MEXICO AVE NW STE 240
WASHINGTON DC
20016-3610
US

IV. Provider business mailing address

3301 NEW MEXICO AVE NW STE 240
WASHINGTON DC
20016-3610
US

V. Phone/Fax

Practice location:
  • Phone: 202-966-8814
  • Fax: 202-966-7001
Mailing address:
  • Phone: 202-966-8814
  • Fax: 202-966-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberMD043088
License Number StateDC

VIII. Authorized Official

Name: DR. THOMAS LEENEY ADRIAN
Title or Position: OWNER
Credential: MD
Phone: 202-966-8814