Doctor Name: | LEROY LEONARD |
NPI Number: | 1407247448 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP |
License Number: | F338857 |
Business Practice Address: | 160 E Main St Port Jervis, NY - 127712253 |
Business Phone Number: | 8458587100 |
Business Fax Number: | |
Mailing Address: | 484 Temple Hill Rd, Suite 102 NEW WINDSOR |
State: | NY |
Postal Code: | 125535557 |
Phone Number: | 8455653700 |
Fax Number: | |
NPI Enumeration Date: | 02/12/2015 |
NPI Last Update Date: | 02/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F338857 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |