Healthcare Provider Details

I. General information

NPI: 1457694010
Provider Name (Legal Business Name): THOMAS LEENEY ADRIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2013
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 TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD043088
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: