Provider Demographics
NPI:1124598339
Name:SAMEDY, LESLY-ANNE (PHARMD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LESLY-ANNE
Middle Name:
Last Name:SAMEDY
Suffix:
Gender:F
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 43RD ST APT 25
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-3789
Mailing Address - Country:US
Mailing Address - Phone:301-807-2471
Mailing Address - Fax:
Practice Address - Street 1:1000 43RD ST APT 25
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-3789
Practice Address - Country:US
Practice Address - Phone:301-807-2471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76898183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist