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NPI Code Detail

MEDICARE: EDDINA LEONARD

MEDICARE:   EDDINA  LEONARD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse584196NY

General Provider Information

NPI Number : 1558745216
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDDINA LEONARD
Provider Business Mailing Address
First Line : 5A HEMLOCK DR APT 95
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-2913
Country : US
Telephone Number : 516-946-9167
Fax Number :
Provider Business Practice Location Address
First Line : 5A HEMLOCK DR APT 95
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-2913
Country : US
Telephone Number : 516-946-9167
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2015
Last Update Date : 07/13/2015

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Directions to “ EDDINA LEONARD ” Practice Location

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