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General NPI Number Information
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NPI Number | 1063874550
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Entity Type | Individual
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Provider Name | LESHAUN ANGMOR F.N.P
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Gender | Female
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 315 2ND AVE SUITE 2
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City | TROY
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State | NY
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Zip | 12182-3237
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Country | US
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Telephone | 518-235-8034
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Fax |
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Provider Business Mailing Address
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Address Line | 2 MOUNTAIN VIEW TER APT 7
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City | LATHAM
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State | NY
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Zip | 12110-2049
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Country | US
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Telephone | 518-491-6601
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F340500-1
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License Number State | NY
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