Provider Demographics
NPI:1881342822
Name:FIOLEK-HESS, LESLIE R
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:R
Last Name:FIOLEK-HESS
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 1:3735 W LAKE RD STE A
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3456
Mailing Address - Country:US
Mailing Address - Phone:814-490-0833
Mailing Address - Fax:
Practice Address - Street 1:3735 W LAKE RD STE A
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-3456
Practice Address - Country:US
Practice Address - Phone:814-490-0833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA5180246ZA2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical