Provider Demographics
NPI:1295880292
Name:FINEBERG, LEAH (DOM)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:FINEBERG
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4012 OLD SANTA FE TRL
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4500
Mailing Address - Country:US
Mailing Address - Phone:505-983-5387
Mailing Address - Fax:505-986-1190
Practice Address - Street 1:200 W DE VARGAS ST
Practice Address - Street 2:SUITE 5
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-2643
Practice Address - Country:US
Practice Address - Phone:505-983-5387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM132171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist