Provider Demographics
NPI:1558562843
Name:LESHINSKY, KEVIN (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:LESHINSKY
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 GREEN ST
Mailing Address - Street 2:APT 5B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-1309
Mailing Address - Country:US
Mailing Address - Phone:917-674-7448
Mailing Address - Fax:
Practice Address - Street 1:151 GREEN ST
Practice Address - Street 2:APT 5B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-1309
Practice Address - Country:US
Practice Address - Phone:917-674-7448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006982363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant