Provider Demographics
NPI:1235549940
Name:ZECKSER, LESLIE ANN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANN
Last Name:ZECKSER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8573 E PRINCESS DR
Mailing Address - Street 2:SUITE B-215
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7819
Mailing Address - Country:US
Mailing Address - Phone:480-563-5757
Mailing Address - Fax:480-563-5851
Practice Address - Street 1:8573 E PRINCESS DR
Practice Address - Street 2:SUITE B-215
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7819
Practice Address - Country:US
Practice Address - Phone:480-563-5757
Practice Address - Fax:480-563-5851
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5703363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ102830OtherGROUP PTAN
AZ1925Other1925
AZ917410Medicaid
AZ917410Medicaid