Provider Demographics
NPI:1699855338
Name:DANSKIN, LESLEY ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:ANNE
Last Name:DANSKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 VALLEY VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-9307
Mailing Address - Country:US
Mailing Address - Phone:518-285-8100
Mailing Address - Fax:518-285-8145
Practice Address - Street 1:295 VALLEY VIEW BLVD
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-9307
Practice Address - Country:US
Practice Address - Phone:518-285-8100
Practice Address - Fax:518-285-8145
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179641208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01698360Medicaid
NY01698360Medicaid