Provider Demographics
NPI:1598786782
Name:PYENSON, LESLIE RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:RICHARD
Last Name:PYENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 BEECH HILL DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1945
Mailing Address - Country:US
Mailing Address - Phone:301-365-5710
Mailing Address - Fax:301-365-0941
Practice Address - Street 1:9220 BEECH HILL DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1945
Practice Address - Country:US
Practice Address - Phone:301-365-5710
Practice Address - Fax:301-365-0941
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0026677207R00000X
DCMD15621207R00000X
VA0101030624207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine