MEDICARE: JULIA LESZKO RPH

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	183500000X	Pharmacist	03319890	OH

General Provider Information

NPI Number	:	1922384718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA LESZKO RPH

Provider Business Mailing Address
First Line	:	3012 MEADOWBROOK BLVD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44118-2847
Country	:	US
Telephone Number	:	503-901-0091
Fax Number	:

Provider Business Practice Location Address
First Line	:	9211 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-2043
Country	:	US
Telephone Number	:	216-444-2119
Fax Number	:	216-445-6015

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

Provider Enumeration Date	:	10/25/2011
Last Update Date	:	10/25/2011

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