Provider Demographics
NPI:1841176369
Name:ACHA, LESLEY AMBAN
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:AMBAN
Last Name:ACHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5024 TOWNSEND WAY APT C4
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1876
Mailing Address - Country:US
Mailing Address - Phone:240-388-0135
Mailing Address - Fax:
Practice Address - Street 1:5024 TOWNSEND WAY APT C4
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1876
Practice Address - Country:US
Practice Address - Phone:240-388-0135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide