MEDICARE: DR. PETER LESNIEWSKI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	036120290	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205885001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER LESNIEWSKI MD

Provider Business Mailing Address
First Line	:	1650 GRAND CONCOURSE
Second Line	:	DEPT OF ORTHOPAEDICS
City	:	BRONX
State	:	NY
Zip	:	10457-7606
Country	:	US
Telephone Number	:	718-960-4526
Fax Number	:	718-466-8168

Provider Business Practice Location Address
First Line	:	1650 SELWYN AVE
Second Line	:	13E
City	:	BRONX
State	:	NY
Zip	:	10457-7626
Country	:	US
Telephone Number	:	718-960-4526
Fax Number	:	718-466-8168

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	02/28/2010

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