Healthcare Provider Details

I. General information

NPI: 1790947208
Provider Name (Legal Business Name): DANIELLE J LECKY-CHAUDHURI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

656 INDEPENDENCE PKWY STE 200
CHESAPEAKE VA
23320-5213
US

IV. Provider business mailing address

656 INDEPENDENCE PKWY STE 200
CHESAPEAKE VA
23320-5213
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-5126
  • Fax: 757-410-3631
Mailing address:
  • Phone: 757-668-5126
  • Fax: 757-410-3631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberD0076034
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101248341
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: