Dork, Leslie A
Dork, Leslie A is an individual health care provider with primary practice located at 3821 Masthead St Ne , Albuquerque NM 87109-4679. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Dork, Leslie A can be contacted via phone (505) 998-7400.Contact Information
Primary practice address
3821 Masthead St Ne
Albuquerque NM 87109-4679
Phone: (505) 998-7400
Fax: (505) 998-7741
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | R33302 | New Mexico |
Profile Details
| NPI number | 1790703361 |
|---|---|
| LBN Legal business name | Dork, Leslie A |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Mar 30th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790703361 | NPPES |
| New Mexico | MEDICAID | 51089262 |
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