Provider Demographics
NPI:1528162138
Name:LESKO, MARY (CNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:LESKO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:245 MEADOWLANE RD
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-6124
Mailing Address - Country:US
Mailing Address - Phone:216-559-0610
Mailing Address - Fax:330-665-6748
Practice Address - Street 1:762 S CLEVELAND MASSILLON RD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3024
Practice Address - Country:US
Practice Address - Phone:330-665-4100
Practice Address - Fax:330-665-4100
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHNP-3032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner