Provider Demographics
NPI:1124383252
Name:LESKO, LYNNA M (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LYNNA
Middle Name:M
Last Name:LESKO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 RICHARDS RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH KENT
Mailing Address - State:CT
Mailing Address - Zip Code:06785-1304
Mailing Address - Country:US
Mailing Address - Phone:860-927-3370
Mailing Address - Fax:
Practice Address - Street 1:104 RICHARDS RD
Practice Address - Street 2:
Practice Address - City:SOUTH KENT
Practice Address - State:CT
Practice Address - Zip Code:06785-1304
Practice Address - Country:US
Practice Address - Phone:860-927-3370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-04
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0425412084P0800X, 2084P2900X
CAG416672084P0800X
NY1527272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine