Provider Demographics
NPI:1558859579
Name:LESLIE G LAFER, DOPLLC
Entity Type:Organization
Organization Name:LESLIE G LAFER, DOPLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STONIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-948-9508
Mailing Address - Street 1:1437 E 12 MILE ROAD
Mailing Address - Street 2:BUILDING D
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071
Mailing Address - Country:US
Mailing Address - Phone:248-948-9508
Mailing Address - Fax:248-948-9158
Practice Address - Street 1:1437 E 12 MILE ROAD
Practice Address - Street 2:BUILDING D
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071
Practice Address - Country:US
Practice Address - Phone:248-948-9508
Practice Address - Fax:248-948-9158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty