Provider Demographics
NPI:1962492959
Name:LESZKOWICZ, ADITEE D (DO)
Entity Type:Individual
Prefix:DR
First Name:ADITEE
Middle Name:D
Last Name:LESZKOWICZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ADITEE
Other - Middle Name:A
Other - Last Name:DEODHAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:500 LIPPINCOTT DR
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4802
Practice Address - Country:US
Practice Address - Phone:856-988-9101
Practice Address - Fax:856-988-7712
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07751000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0047414Medicaid
NJ0047414Medicaid