Provider Demographics
NPI:1033444187
Name:CANTAVE-LEROY, VALERIE
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:CANTAVE-LEROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16317 130TH AVE
Mailing Address - Street 2:APT 7B
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3029
Mailing Address - Country:US
Mailing Address - Phone:718-276-9540
Mailing Address - Fax:
Practice Address - Street 1:16317 130TH AVE
Practice Address - Street 2:APT 7B
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3029
Practice Address - Country:US
Practice Address - Phone:718-276-9540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY619191163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse