Provider Demographics
NPI:1760422794
Name:DEGIOVANNI, LESLEY (MD)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:DEGIOVANNI
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 1:1000 BOWER HILL RD
Mailing Address - Street 2:ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN PATNESK
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-2548
Mailing Address - Fax:
Practice Address - Street 1:717 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-2001
Practice Address - Country:US
Practice Address - Phone:412-341-7887
Practice Address - Fax:412-341-1479
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040419E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016110930002Medicaid
613672HBNMedicare PIN
PAE55827Medicare UPIN
PA0016110930002Medicaid