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General NPI Number Information
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NPI Number | 1861518367
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Entity Type | Individual
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Provider Name | LESLIE ANN MARRA NP
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 21 BLOOMINGDALE RD
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City | WHITE PLAINS
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State | NY
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Zip | 10605-1504
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Country | US
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Telephone | 914-997-5762
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Fax | 914-997-8635
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Provider Business Mailing Address
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Address Line | 82 EDGEWOOD RD
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City | OSSINING
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State | NY
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Zip | 10562-2710
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Country | US
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Telephone | 914-941-4924
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Fax | 914-997-8635
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 400315
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License Number State | NY
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