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NPI Code Detail

MEDICARE: DR. THOMAS HENRY LESNIK M.D.

MEDICARE: DR. THOMAS HENRY LESNIK M.D.
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
1207YX0905XOtolaryngology/Facial Plastic Surgery Physician016431CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1502758OTHERCTAETNA
2030800OTHERHEALTHNET
3010016431CT01OTHERCOANTHEM BC/BS

General Provider Information

NPI Number : 1477538205
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS HENRY LESNIK M.D.
Provider Business Mailing Address
First Line : 119 LAFAYETTE ST
Second Line :
City : NORWICH
State : CT
Zip : 06360-2708
Country : US
Telephone Number : 860-886-1947
Fax Number : 860-823-1644
Provider Business Practice Location Address
First Line : 119 LAFAYETTE ST
Second Line :
City : NORWICH
State : CT
Zip : 06360-2708
Country : US
Telephone Number : 860-886-1947
Fax Number : 860-823-1644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 07/08/2007

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