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Individual
LESLIE ROSENBLATT-BROWN
Active
Individual
LESLIE ROSENBLATT-BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3987
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10033138
AMERIGROUP
GA
01
—
319981
WELLCARE
GA
05
—
451479533A
—
GA
Enumeration date
08/30/2006
Last updated
09/01/2010
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