Provider Demographics
NPI:1528476215
Name:LESSEY, GAYATRI (MBBS)
Entity type:Individual
Prefix:
First Name:GAYATRI
Middle Name:
Last Name:LESSEY
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 KANAWHA AVE SW STE 402
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1367
Mailing Address - Country:US
Mailing Address - Phone:304-400-4700
Mailing Address - Fax:
Practice Address - Street 1:8926 WOODYARD RD STE 602
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4235
Practice Address - Country:US
Practice Address - Phone:301-868-9414
Practice Address - Fax:301-868-6055
Is Sole Proprietor?:No
Enumeration Date:2014-07-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101279078207RN0300X
390200000X
MDD0097366207RN0300X
WV28865207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program