Provider Demographics
NPI:1780175471
Name:PELAKH, LESLIE
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:PELAKH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10824 HIGHPOINT DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-1832
Mailing Address - Country:US
Mailing Address - Phone:321-368-8711
Mailing Address - Fax:
Practice Address - Street 1:1404 BALTIMORE ST STE 4
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-8698
Practice Address - Country:US
Practice Address - Phone:717-637-0470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant