Basic Information
| Provider Information | |||||||||
| NPI: | 1427225887 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BORNSTEIN LURIE | ||||||||
| FirstName: | LEIGH | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BORNSTEIN | ||||||||
| OtherFirstName: | LEIGH | ||||||||
| OtherMiddleName: | HELEN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 14955 SHADY GROVE RD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208508700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3013403252 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 14955 SHADY GROVE RD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208508700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3013403252 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2008 | ||||||||
| LastUpdateDate: | 09/26/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0101247785 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | DC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RG0100X | D72288 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.