Healthcare Provider Details

I. General information

NPI: 1376460147
Provider Name (Legal Business Name): JOANNA LEYKO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 POTTERSVILLE RD
CHESTER NJ
07930-2432
US

IV. Provider business mailing address

112 STONEGATE LN
STANHOPE NJ
07874-2712
US

V. Phone/Fax

Practice location:
  • Phone: 908-895-4931
  • Fax:
Mailing address:
  • Phone: 973-945-8236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number26NR18575300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: