Provider Demographics
NPI:1114799830
Name:BORYCZEWSKI, LEANDRO (MS)
Entity Type:Individual
Prefix:MR
First Name:LEANDRO
Middle Name:
Last Name:BORYCZEWSKI
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 MURPHY LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-7586
Mailing Address - Country:US
Mailing Address - Phone:170-429-0738
Mailing Address - Fax:
Practice Address - Street 1:4502 MURPHY LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-7586
Practice Address - Country:US
Practice Address - Phone:704-290-7386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist