Healthcare Provider Details
I. General information
NPI: 1053311290
Provider Name (Legal Business Name): FRANK A LESCOSKY D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/29/2005
Last Update Date: 12/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2100 HEMBY LN
GREENVILLE NC
27834-3996
US
IV. Provider business mailing address
2100 HEMBY LN
GREENVILLE NC
27834-3996
US
V. Phone/Fax
- Phone: 252-757-1600
- Fax: 252-830-6244
- Phone: 252-757-1600
- Fax: 252-830-6244
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 186 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | 186 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: