Provider Demographics
NPI:1487824926
Name:ROCHESTER, LESLIE KAREN (LPN)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:KAREN
Last Name:ROCHESTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1647 COBBS CREEK PKWY
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-5212
Mailing Address - Country:US
Mailing Address - Phone:215-730-9383
Mailing Address - Fax:215-235-3311
Practice Address - Street 1:112 N BROAD ST
Practice Address - Street 2:RM 821
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19102-1510
Practice Address - Country:US
Practice Address - Phone:215-568-0860
Practice Address - Fax:215-568-0769
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN105793L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse