Provider Demographics
NPI:1578714648
Name:MEALY, LEFTERIA D (PA-C)
Entity Type:Individual
Prefix:
First Name:LEFTERIA
Middle Name:D
Last Name:MEALY
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Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 POWDER MILL RD
Mailing Address - Street 2:PO BOX
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-2907
Mailing Address - Country:US
Mailing Address - Phone:302-695-2437
Mailing Address - Fax:302-695-1364
Practice Address - Street 1:200 POWDER MILL RD
Practice Address - Street 2:PO BOX
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2907
Practice Address - Country:US
Practice Address - Phone:302-695-2437
Practice Address - Fax:302-695-1364
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2016-04-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
141050ZB9MMedicare PIN