Individual
LEEZA NICOLE FARAONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0100
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C08250
MD
Other
Enumeration date
10/19/2020
Last updated
10/12/2022
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