Provider Demographics
NPI:1780631721
Name:LESLEY DEGIOVANNI MD, PC
Entity Type:Organization
Organization Name:LESLEY DEGIOVANNI MD, PC
Other - Org Name:PRIMARY CARE INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGIOVANNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-341-7887
Mailing Address - Street 1:717 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-2001
Mailing Address - Country:US
Mailing Address - Phone:412-341-7887
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016110930003Medicaid
PAE55827Medicare UPIN
PA0016110930003Medicaid