Provider Demographics
NPI:1659536464
Name:STEFANSKY, LEOKADIA (PA)
Entity Type:Individual
Prefix:
First Name:LEOKADIA
Middle Name:
Last Name:STEFANSKY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 S. ATWOOD ROAD
Mailing Address - Street 2:STE. 100
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014
Mailing Address - Country:US
Mailing Address - Phone:410-877-7777
Mailing Address - Fax:410-638-9956
Practice Address - Street 1:602 S ATWOOD RD
Practice Address - Street 2:100
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4172
Practice Address - Country:US
Practice Address - Phone:410-877-7777
Practice Address - Fax:410-638-9956
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001315363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical