Basic Information
| Provider Information | |||||||||
| NPI: | 1033149422 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAUL | ||||||||
| FirstName: | LEENA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10925 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198500925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027094587 | ||||||||
| FaxNumber: | 3027092402 | ||||||||
| Practice Location | |||||||||
| Address1: | 640 S STATE ST | ||||||||
| Address2: | |||||||||
| City: | DOVER | ||||||||
| State: | DE | ||||||||
| PostalCode: | 19901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026744700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 02/12/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | C10006941 | DE | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 239192ZAD5 | 01 | DE | MEDICARE PTAN | OTHER | P01052316 | 01 | DE | MEDICARE RAIL ROAD PTAN | OTHER |