Healthcare Provider Details

I. General information

NPI: 1093049355
Provider Name (Legal Business Name): THOMASLESLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2009
Last Update Date: 09/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 BONNIE CT
SPRING VALLEY NY
10977-2200
US

IV. Provider business mailing address

17 BONNIE CT
SPRING VALLEY NY
10977-2200
US

V. Phone/Fax

Practice location:
  • Phone: 845-362-0792
  • Fax:
Mailing address:
  • Phone: 845-362-0792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. LESLY THOMAS
Title or Position: LPN
Credential: LPN
Phone: 845-362-0792