Provider Demographics
NPI:1346357670
Name:LEIGH, JULIE FREIDLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:FREIDLIN
Last Name:LEIGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:FREIDLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8150 LEESBURG PIKE
Mailing Address - Street 2:SUITE #909
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-7715
Mailing Address - Country:US
Mailing Address - Phone:703-790-1780
Mailing Address - Fax:703-734-0491
Practice Address - Street 1:8150 LEESBURG PIKE
Practice Address - Street 2:SUITE #909
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-7715
Practice Address - Country:US
Practice Address - Phone:703-790-1780
Practice Address - Fax:703-734-0491
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95054207W00000X
VA0101241671207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A950540Medicaid
CA00A950540Medicare PIN