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General NPI Number Information
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NPI Number | 1366399883
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Entity Type | Individual
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Provider Name | MATTHEW JAMES LECKE
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Gender | Male
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 260 S PEARL ST # 12202
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City | ALBANY
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State | NY
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Zip | 12202-1809
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Country | US
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Telephone | 518-447-4555
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Fax |
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Provider Business Mailing Address
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Address Line | 260 S PEARL ST # 12202
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City | ALBANY
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State | NY
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Zip | 12202-1809
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Country | US
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Telephone | 518-447-4555
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 723984
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 723984
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 723984
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 163WN1003X
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Taxonomy Name | Nutrition Support Registered Nurse
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License Number | 723984
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 723984
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 723984
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 723984
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License Number State | NY
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Taxonomy #8
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 723984
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License Number State | NY
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Taxonomy #9
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 723984
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License Number State | NY
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