Provider Demographics
NPI:1144409780
Name:LEBLEU-VASZILY, LAURIE RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:RENEE
Last Name:LEBLEU-VASZILY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURIE
Other - Middle Name:RENEE
Other - Last Name:LEBLEU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:312 GRAMMONT ST
Mailing Address - Street 2:STE 300
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7403
Mailing Address - Country:US
Mailing Address - Phone:610-434-4015
Mailing Address - Fax:610-435-4821
Practice Address - Street 1:312 GRAMMONT ST
Practice Address - Street 2:STE 300
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7403
Practice Address - Country:US
Practice Address - Phone:318-398-2373
Practice Address - Fax:318-998-3999
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202156207V00000X
PAMD465664207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1144878Medicaid
LA4N138C148Medicare PIN
NC41136BMedicare UPIN