Basic Information
| Provider Information | |||||||||
| NPI: | 1184629230 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREENBERG | ||||||||
| FirstName: | LESLIE | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 W. SECOND ST. | ||||||||
| Address2: | #235D | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7756828176 | ||||||||
| FaxNumber: | 7753272006 | ||||||||
| Practice Location | |||||||||
| Address1: | 123 17TH ST. | ||||||||
| Address2: | MS 316 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757841533 | ||||||||
| FaxNumber: | 7757848075 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2005 | ||||||||
| LastUpdateDate: | 09/02/2015 | ||||||||
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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 | 207Q00000X | 0426388 | KS | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 15871 | NV | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.