Basic Information
Provider Information
NPI: 1013010412
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRICKLER
FirstName: LESLIE
MiddleName: ERIN
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2211 LOMAS BLVD NE
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871062745
CountryCode: US
TelephoneNumber: 5052725551
FaxNumber: 5052726845
Practice Location
Address1: 2211 LOMAS BLVD NE
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871062745
CountryCode: US
TelephoneNumber: 5052725551
FaxNumber: 5052726845
Other Information
ProviderEnumerationDate: 09/07/2006
LastUpdateDate: 05/11/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XA136106NMY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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