Provider Demographics
NPI:1043062508
Name:PEREZ, LEANNE MARIE
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:MARIE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4954 PALMER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH, BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:301-319-5437
Mailing Address - Fax:
Practice Address - Street 1:4954 PALMER RD
Practice Address - Street 2:
Practice Address - City:NORTH, BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-319-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program