Individual
LESHAWN TANKSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
522 SILVERTON PL, PISCATAWAY, NJ 08854-1479
(908) 425-5683
Mailing address
522 SILVERTON PL, PISCATAWAY, NJ 08854-1479
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
32W101197700
NJ
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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