Provider Demographics
NPI:1982622536
Name:LESHO, EMIL PATRICK (DO)
Entity type:Individual
Prefix:
First Name:EMIL
Middle Name:PATRICK
Last Name:LESHO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1425 PORTLAND AVE # 246
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3001
Mailing Address - Country:US
Mailing Address - Phone:585-922-4003
Mailing Address - Fax:585-922-5168
Practice Address - Street 1:1425 PORTLAND AVE # 246
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3001
Practice Address - Country:US
Practice Address - Phone:585-922-4003
Practice Address - Fax:585-922-5168
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285847207RI0200X
PAOS007603L207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04542545Medicaid
MD321004900Medicaid
MD1471282AL4Medicare PIN