Basic Information
| Provider Information | |||||||||
| NPI: | 1316998545 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LESCHEK-GELMAN | ||||||||
| FirstName: | LISA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 774 CHRISTIANA RD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197134236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027313017 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1151 OLD YORK RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190013816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159579250 | ||||||||
| FaxNumber: | 2159579254 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2006 | ||||||||
| LastUpdateDate: | 02/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0600X | MD061589L | PA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Clinical Neurophysiology | 2084S0012X | MD061589L | PA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Sleep Medicine | 2084N0400X | MD061589L | PA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | C1-0005405 | DE | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 918101 | 05 | DE | MEDICAID |