Healthcare Provider Details

I. General information

NPI: 1740360692
Provider Name (Legal Business Name): DENNIS PAUL LESNIAK MA, CCC/A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 SEVERANCE CIR
CLEVELAND HEIGHTS OH
44118-1533
US

IV. Provider business mailing address

10 SEVERANCE CIR
CLEVELAND HEIGHTS OH
44118-1533
US

V. Phone/Fax

Practice location:
  • Phone: 216-297-2651
  • Fax: 216-297-2658
Mailing address:
  • Phone: 216-297-2651
  • Fax: 216-297-2658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA 00393
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: