Healthcare Provider Details

I. General information

NPI: 1083660112
Provider Name (Legal Business Name): LESLIE D. KLABBATZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4065 CENTER RD
BRUNSWICK OH
44212-2918
US

IV. Provider business mailing address

8010 BROOK CIR
MACEDONIA OH
44056-2359
US

V. Phone/Fax

Practice location:
  • Phone: 440-816-5585
  • Fax:
Mailing address:
  • Phone: 330-468-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.069253
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number35069253K
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: