Provider Demographics
NPI:1588662910
Name:LEARY, PATRICK JAMES (M D)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JAMES
Last Name:LEARY
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6317 BEACHWAY DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-1510
Mailing Address - Country:US
Mailing Address - Phone:703-845-5845
Mailing Address - Fax:
Practice Address - Street 1:6317 BEACHWAY DR
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-1510
Practice Address - Country:US
Practice Address - Phone:703-845-5845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101012702207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5941Medicare UPIN