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General NPI Number Information
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NPI Number | 1730640855
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Entity Type | Individual
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Provider Name | LEILANI PATHAK MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 950 N GLEBE RD STE 700
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City | ARLINGTON
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State | VA
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Zip | 22203-4173
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Country | US
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Telephone | 703-971-0505
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Fax |
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Provider Business Mailing Address
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Address Line | 1 BROOKDALE PLZ
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City | BROOKLYN
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State | NY
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Zip | 11212-3139
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Country | US
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Telephone |
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 0101281978
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License Number State | VA
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