Individual
LESLEY GRADONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDN
Contact information
Practice address
1307 FEDERAL ST STE B100, PITTSBURGH, PA 15212-4761
(412) 359-8900
Mailing address
1307 FEDERAL ST STE B100, PITTSBURGH, PA 15212-4761
(412) 359-8900
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006459
PA
133VN1004X
Pediatric Nutrition Registered Dietitian
DN006459
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103512598
—
PA
01
—
14277787
CAQH
—
Enumeration date
07/04/2018
Last updated
11/19/2020
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