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NPI Code Detail

MEDICARE: AMY LEEDS

MEDICARE: AMY LEEDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1346622107
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY LEEDS
Provider Business Mailing Address
First Line : 12 CAMBRIDGE RD
Second Line :
City : HIGHLAND MILLS
State : NY
Zip : 10930-2612
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1125 FULTON ST
Second Line : 2ND FLOOR
City : BROOKLYN
State : NY
Zip : 11238-2669
Country : US
Telephone Number : 347-226-9025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2015
Last Update Date : 06/29/2015

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Directions to “ AMY LEEDS ” Practice Location

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