Masciarelli Kisch, Leslie R
Masciarelli Kisch, Leslie R is an individual health care provider with primary practice located at 918 Washington Ave Optical Eyedeas, Detroit Lakes MN 56501. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Masciarelli Kisch, Leslie R can be contacted via phone (218) 847-8021.Contact Information
Primary practice address
918 Washington Ave Optical Eyedeas
Detroit Lakes MN 56501
Phone: (218) 847-8021
Fax: (218) 846-9552
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2319 | Minnesota |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 490 | North Dakota |
Profile Details
| NPI number | 1699876417 |
|---|---|
| LBN Legal business name | Masciarelli Kisch, Leslie R |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1699876417 | NPPES |
| Minnesota | Other | 2202047 | MEDICA |
| Minnesota | Other | 36B56MA | MEDICA |
| Minnesota | Other | 2202048 | MEDICA |
| Minnesota | Other | 2207652 | MEDICA |
| Minnesota | Other | 283R7MA | MEDICA |
| Minnesota | Other | 283R8MA | MEDICA |
Popular Providers
-
Hansen, Gina
1234 Washington Ave Ste A , Detroit Lakes MN 56501-3906 -
Mothershed, Fred H
3353 N Gloster St , Tupelo MS 38804-9735 -
Quitberg, Joy M
1245 Washington Ave , Detroit Lakes MN 56501-3905 -
Smothers-Champley, Debra
900 W Springfield Rd , Taylorville IL 62568-1213 -
Roth, Reed T
28370 Kensington Ln Suite A, Perrysburg OH 43551-4163 -
Varley, Richard W
508 W Chickasha Ave , Chickasha OK 73018-2412 -
Brudner, Peter N.
425 W Central Ave , Lompoc CA 93436-2805 -
Sude, Jerome
3510 Manchester Rd , Coventry Township OH 44319-1415