Provider Demographics
NPI:1023202983
Name:VOGEL, LESLEY BONANNO (RD, LD)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:BONANNO
Last Name:VOGEL
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:LESLEY
Other - Middle Name:ANNE
Other - Last Name:BONANNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:THE JOHNS HOPKINS HOSPITAL CMSC B100
Mailing Address - Street 2:600 N. WOLFE STREET
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0001
Mailing Address - Country:US
Mailing Address - Phone:410-955-6716
Mailing Address - Fax:
Practice Address - Street 1:THE JOHNS HOPKINS HOSPITAL CMSC B100
Practice Address - Street 2:600 N. WOLFE STREET
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:410-955-6716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD01580133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered