Provider Demographics
NPI:1538593777
Name:LESHNER MELTZER, FAITH MICHELLE (LAC, LOM, DIPLO, DAC)
Entity type:Individual
Prefix:DR
First Name:FAITH
Middle Name:MICHELLE
Last Name:LESHNER MELTZER
Suffix:
Gender:F
Credentials:LAC, LOM, DIPLO, DAC
Other - Prefix:DR
Other - First Name:FAITH
Other - Middle Name:MICHELLE
Other - Last Name:LESHNER MELTZER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, LOM, DIPLO, DAC
Mailing Address - Street 1:59 PORTSMOUTH CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2621
Mailing Address - Country:US
Mailing Address - Phone:267-968-1478
Mailing Address - Fax:
Practice Address - Street 1:6 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1533
Practice Address - Country:US
Practice Address - Phone:267-968-1479
Practice Address - Fax:267-274-9179
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2022-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001091171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1538593777Medicaid