Healthcare Provider Details

I. General information

NPI: 1710553227
Provider Name (Legal Business Name): L SQUARED HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 11/08/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 GLASGOW AVE STE 200
NEWARK DE
19702-5704
US

IV. Provider business mailing address

2600 GLASGOW AVE STE 200
NEWARK DE
19702-5704
US

V. Phone/Fax

Practice location:
  • Phone: 302-289-5425
  • Fax: 866-347-3120
Mailing address:
  • Phone: 302-289-5425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW LEITZKE
Title or Position: MEMEBR
Credential:
Phone: 302-289-5425