MEDICARE: KATARZYNA LESNIAK-KARPIAK PH.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	103G00000X	Clinical Neuropsychologist	PSO15548	PA

General Provider Information

NPI Number	:	1801877600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATARZYNA LESNIAK-KARPIAK PH.D.

Provider Business Mailing Address
First Line	:	104 INDIAN RUN DR
Second Line	:
City	:	DOUGLASSVILLE
State	:	PA
Zip	:	19518-8988
Country	:	US
Telephone Number	:	484-686-5582
Fax Number	:	610-689-0261

Provider Business Practice Location Address
First Line	:	39 OLD SWEDE RD
Second Line	:	SUITE C
City	:	DOUGLASSVILLE
State	:	PA
Zip	:	19518-1852
Country	:	US
Telephone Number	:	484-686-5582
Fax Number	:	610-689-0261

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	10/27/2007

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