Provider Demographics
NPI:1780652982
Name:LESLIE, DENISE R (MD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:R
Last Name:LESLIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:141 S CENTRAL AVE
Mailing Address - Street 2:C/O HARTSDALE IMAGING
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2319
Mailing Address - Country:US
Mailing Address - Phone:914-761-4030
Mailing Address - Fax:914-949-2931
Practice Address - Street 1:141 S CENTRAL AVE
Practice Address - Street 2:C/O HARTSDALE IMAGING
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-2319
Practice Address - Country:US
Practice Address - Phone:914-761-4030
Practice Address - Fax:914-949-2931
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1507152085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01106812Medicaid
NY300092540OtherRAILROAD MEDICARE
NY300104586OtherRAILROAD MEDICARE
NY300107702OtherRAILROAD MEDICARE
NY300107703OtherRAILROAD MEDICARE
NY300077612OtherRAILROAD MEDICARE
NY300104585OtherRAILROAD MEDICARE
NY300107701OtherRAILROAD MEDICARE
NY300107704OtherRAILROAD MEDICARE
NY300104584OtherRAILROAD MEDICARE
NY300104587OtherRAILROAD MEDICARE
NY300107702OtherRAILROAD MEDICARE
NY300107703OtherRAILROAD MEDICARE