Provider Demographics
NPI:1316155161
Name:LESHAN, NORMAN JASON (RPH)
Entity type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:JASON
Last Name:LESHAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6364A SPRINGFIELD PLZ
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-3431
Mailing Address - Country:US
Mailing Address - Phone:703-569-5401
Mailing Address - Fax:703-866-5633
Practice Address - Street 1:6364A SPRINGFIELD PLZ
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-3431
Practice Address - Country:US
Practice Address - Phone:703-323-5209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202001507183500000X, 1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Yes183500000XPharmacy Service ProvidersPharmacist