Provider Demographics
NPI:1154721769
Name:LEJKOWSKI, CHRISTY LYNN (PA-C)
Entity type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:LYNN
Last Name:LEJKOWSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:LYNN
Other - Last Name:PICCOLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:409 SOUTH FRONT STREET
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1621
Mailing Address - Country:US
Mailing Address - Phone:717-506-4720
Mailing Address - Fax:717-506-4734
Practice Address - Street 1:910 CENTURY DR
Practice Address - Street 2:SUITE 150
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-8424
Practice Address - Country:US
Practice Address - Phone:717-506-4720
Practice Address - Fax:717-506-4734
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA057023363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103146119Medicaid
PA103146119Medicaid