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General NPI Number Information
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NPI Number | 1154710028
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Entity Type | Individual
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Provider Name | TANYA LEIGH LECIEJEWSKI DPT
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Gender | Female
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 5901 MACARTHUR BLVD NW
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City | WASHINGTON
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State | DC
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Zip | 20016-2541
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Country | US
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Telephone | 202-349-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 SPRING FOREST RD
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City | RALEIGH
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State | NC
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Zip | 27616-2815
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Country | US
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Telephone | 919-424-5080
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P13587
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License Number State | NC
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