| Doctor Name: | MRS. KIM MARIE LEIDNER |
| NPI Number: | 1790853745 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSRD, CDE |
| License Number: | 806597 |
| Business Practice Address: | 986 Sunrise Hwy West Babylon, NY - 117046111 |
| Business Phone Number: | 6315876060 |
| Business Fax Number: | 6315871364 |
| Mailing Address: | 34 Stratford Ave, GREENLAWN |
| State: | NY |
| Postal Code: | 117402519 |
| Phone Number: | 6313683706 |
| Fax Number: | 6313681027 |
| NPI Enumeration Date: | 11/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 806597 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |