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General NPI Number Information
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NPI Number | 1124028147
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Entity Type | Individual
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Provider Name | HANNA LESICKA M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/01/2005
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Last Update Date | 12/26/2011
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Provider Practice Location Address
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Address Line | 217 CALYER ST
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City | BROOKLYN
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State | NY
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Zip | 11222-2702
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Country | US
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Telephone | 718-349-2442
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Fax | 718-349-2243
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Provider Business Mailing Address
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Address Line | 120 97TH ST
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City | BROOKLYN
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State | NY
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Zip | 11209-7602
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Country | US
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Telephone | 718-491-4414
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Fax | 718-492-9758
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 221781
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License Number State | NY
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