Provider Demographics
NPI:1932192473
Name:SWEENEY, LESLEY JAYE (MD)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:JAYE
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LESLEY
Other - Middle Name:J
Other - Last Name:GAYDOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2500 BERNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9453
Mailing Address - Country:US
Mailing Address - Phone:610-378-2440
Mailing Address - Fax:610-378-2441
Practice Address - Street 1:145 N 6TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3096
Practice Address - Country:US
Practice Address - Phone:610-378-2440
Practice Address - Fax:610-378-2441
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054727207V00000X
PAMD444828207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102714697Medicaid
PA30120389OtherAMERIHEALTH MERCY - WMG
PA30120471OtherAMERIHEALTH MERCY - YH
GA711582297AMedicaid
PA2705367OtherHIGHMARK BLUE SHIELD
PA418501OtherUPMC
PA1608898OtherGATEWAY
I11649Medicare UPIN
PA2705367OtherHIGHMARK BLUE SHIELD
PA1608898OtherGATEWAY
GA16BBCKDMedicare ID - Type Unspecified