Provider Demographics
NPI:1437160520
Name:LESHO, JUDITH A (PT)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:A
Last Name:LESHO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 YORK RD
Mailing Address - Street 2:SUITE 236
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7446
Mailing Address - Country:US
Mailing Address - Phone:410-583-0333
Mailing Address - Fax:410-583-2134
Practice Address - Street 1:7801 YORK RD
Practice Address - Street 2:SUITE 236
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7446
Practice Address - Country:US
Practice Address - Phone:410-583-0333
Practice Address - Fax:410-583-2134
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15555225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2227789 00Medicaid
MDKR29SPOtherBCBS
MDKR29SPOtherBCBS