Healthcare Provider Details

I. General information

NPI: 1790195873
Provider Name (Legal Business Name): LEA MARBE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEA RACHMANI

II. Dates (important events)

Enumeration Date: 04/29/2014
Last Update Date: 02/14/2020
Certification Date: 02/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 EASTCHESTER RD
BRONX NY
10461-2301
US

IV. Provider business mailing address

1825 EASTCHESTER RD
BRONX NY
10461-2301
US

V. Phone/Fax

Practice location:
  • Phone: 728-904-2000
  • Fax:
Mailing address:
  • Phone: 718-904-2872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number101525
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number539118-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: