Healthcare Provider Details

I. General information

NPI: 1669050753
Provider Name (Legal Business Name): LESLIE CHIARADONNA DNP-NA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S 8TH ST STE 2I
PHILADELPHIA PA
19106-4017
US

IV. Provider business mailing address

2825 S 12TH ST
PHILADELPHIA PA
19148-4906
US

V. Phone/Fax

Practice location:
  • Phone: 267-322-7700
  • Fax:
Mailing address:
  • Phone: 215-520-6949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN627152
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: