Provider Demographics
NPI:1407804388
Name:BREECH, LESLEY L (MD)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:L
Last Name:BREECH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 2026
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:513-636-9400
Mailing Address - Fax:513-636-0166
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 2026
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3039
Practice Address - Country:US
Practice Address - Phone:513-636-9400
Practice Address - Fax:513-636-0166
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0840032080A0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine