Massoglia, Leslie Glen
Massoglia, Leslie Glen is an sole proprietor health care provider with primary practice located at 4845 Safari Ct N , Eagan MN 55122-2617. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is her primary health care specialty. Massoglia, Leslie Glen can be contacted via phone (507) 461-3813.Contact Information
Primary practice address
4845 Safari Ct N
Eagan MN 55122-2617
Phone: (507) 461-3813
Fax: (952) 431-5334
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 43602 | Minnesota |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | 43602 | Minnesota |
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | 43602 | Minnesota |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207QH0002X | 43602 | Minnesota |
Profile Details
| NPI number | 1992780712 |
|---|---|
| LBN Legal business name | Massoglia, Leslie Glen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 14th, 2005 |
| Last updated | Feb 27th, 2019 - about 5 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 | 1992780712 | NPPES |
| Minnesota | Other | 117R2BA, 015K3BA | BCBS |
| Minnesota | Other | 20153 | BCBS |
| Minnesota | Other | 0107062, 39-09161 | BCBS |
| Minnesota | Other | 117R2BA, 015K3BA | BCBS |
| Minnesota | Other | NA9501028427 | BCBS |
| Minnesota | Other | 080172550 | BCBS |
| Minnesota | Other | 140964 | BCBS |
| Minnesota | MEDICAID | 564110100 | BCBS |
| Minnesota | Other | HP33926 | BCBS |
| Minnesota | Other | 363606405 | BCBS |
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