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General NPI Number Information
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NPI Number | 1790659662
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Entity Type | Organization
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Legal Business Name | 1 CARE PARTNERS KY LLC
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 310 BOXWOOD RUN
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City | MOUNT WASHINGTON
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State | KY
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Zip | 40047-7143
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Country | US
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Telephone | 336-663-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 9505 REISTERSTOWN RD STE 2NW
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City | OWINGS MILLS
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State | MD
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Zip | 21117-4451
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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 | CEO
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Name | GIDEON LEISER
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Credential |
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Telephone | 443-929-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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