MEDICARE: DR. LEKEISHA YOLANDA GEORGE DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	N006236-1	NY

General Provider Information

NPI Number	:	1245482983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEKEISHA YOLANDA GEORGE DPM

Provider Business Mailing Address
First Line	:	7111 110TH ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4851
Country	:	US
Telephone Number	:	718-520-8811
Fax Number	:	718-520-6646

Provider Business Practice Location Address
First Line	:	7111 110TH ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4851
Country	:	US
Telephone Number	:	718-520-8811
Fax Number	:	718-520-6646

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

Provider Enumeration Date	:	10/14/2008
Last Update Date	:	12/30/2014

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