MEDICARE: DR. PATRICK JAMES LEARY 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
1	207VG0400X	Gynecology Physician	0101012702	VA

General Provider Information

NPI Number	:	1588662910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK JAMES LEARY M. D.

Provider Business Mailing Address
First Line	:	6317 BEACHWAY DR
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-1510
Country	:	US
Telephone Number	:	703-845-5845
Fax Number	:

Provider Business Practice Location Address
First Line	:	6317 BEACHWAY DR
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-1510
Country	:	US
Telephone Number	:	703-845-5845
Fax Number	:

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

Provider Enumeration Date	:	07/10/2005
Last Update Date	:	08/10/2007

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