Provider Demographics
NPI:1073819108
Name:LESKO, KRISTY L (MS, SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:L
Last Name:LESKO
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:MISS
Other - First Name:KRISTY
Other - Middle Name:L
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3001 MORGAN DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3001 MORGAN DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2615
Practice Address - Country:US
Practice Address - Phone:845-282-8856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018725-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist