=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851821177
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LESLIANNE BARABASH MSN, RN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2017
-----------------------------------------------------
Last Update Date | 08/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3 FELIX PL
-----------------------------------------------------
City | AMITY HARBOR
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11701-4119
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-371-2543
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 FELIX PL
-----------------------------------------------------
City | AMITY HARBOR
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11701-4119
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 341875
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 341875
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------