Sandra Leni, Md, Llc | |
645 Baltimore Annapolis Boulevard Suite 213 Severna Park MD 21146 | |
(240) 428-0528 | |
Not Available |
Full Name | Sandra Leni, Md, Llc |
---|---|
Speciality | Internal Medicine |
Location | 645 Baltimore Annapolis Boulevard, Severna Park, Maryland |
Authorized Official Name and Position | Sandra Leni (PHYSICIAN) |
Authorized Official Contact | 2404280528 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Sandra Leni, Md, Llc 645 Baltimore Annapolis Boulevard Suite 213 Severna Park MD 21146 Ph: (240) 428-0528 | Sandra Leni, Md, Llc 645 Baltimore Annapolis Boulevard Suite 213 Severna Park MD 21146 Ph: (240) 428-0528 |
NPI Number | 1043616360 |
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Provider Enumeration Date | 11/13/2014 |
Last Update Date | 12/19/2019 |
Medicare PECOS PAC ID | 1951627231 |
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Medicare Enrollment ID | O20150304000386 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043616360 | NPI | - | NPPES |
550010900 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
314000000X | Skilled Nursing Facility | D0071495 (Maryland) | Secondary |
Provider Name | Sandra Leni |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1760490270 PECOS PAC ID: 7911944434 Enrollment ID: I20110810000197 |
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