Provider Demographics
NPI:1073922134
Name:STONE, LESLIE (RPH)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1326
Mailing Address - Country:US
Mailing Address - Phone:301-334-8182
Mailing Address - Fax:301-334-1628
Practice Address - Street 1:220 N 3RD ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1326
Practice Address - Country:US
Practice Address - Phone:301-334-8182
Practice Address - Fax:301-334-1628
Is Sole Proprietor?:No
Enumeration Date:2014-08-03
Last Update Date:2014-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13776183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist