Doctor Name: | MRS. KYLE PENBERTHY LEROY |
NPI Number: | 1134553233 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSED |
License Number: | $$$$$$$$$ |
Business Practice Address: | 43 Conestoga Trl Sparta, NJ - 078712509 |
Business Phone Number: | 9144430138 |
Business Fax Number: | |
Mailing Address: | 26 E Broome St, PORT JERVIS |
State: | NY |
Postal Code: | 127711907 |
Phone Number: | 8453416436 |
Fax Number: | |
NPI Enumeration Date: | 08/26/2013 |
NPI Last Update Date: | 08/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | $$$$$$$$$ |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |