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Individual

LEAH HASKVITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
13350 FRANKLIN FARM RD, STE 100, HERNDON, VA 20171-4091
(703) 810-5206
Mailing address
PO BOX 75420, BALTIMORE, MD 21275-5420
(703) 383-6469
(703) 385-1062

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
R117999
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
0024164355
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
014530101
MD
05
1780681429
VA
Enumeration date
07/07/2005
Last updated
07/16/2024
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