Provider Demographics
NPI:1720014913
Name:LEAO, ZENETTE (MD)
Entity Type:Individual
Prefix:
First Name:ZENETTE
Middle Name:
Last Name:LEAO
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 1:516 INNVOVATION DR.
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3866
Mailing Address - Country:US
Mailing Address - Phone:757-312-8221
Mailing Address - Fax:757-312-8382
Practice Address - Street 1:516 INNVOVATION DR.
Practice Address - Street 2:SUITE 305
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3866
Practice Address - Country:US
Practice Address - Phone:757-312-8221
Practice Address - Fax:757-312-8382
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235696207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA017707M80Medicare PIN
VAI03274Medicare UPIN