Provider Demographics
NPI:1073828877
Name:LEITNER, NIKOL (AUD)
Entity Type:Individual
Prefix:
First Name:NIKOL
Middle Name:
Last Name:LEITNER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 BAINBRIDGE AVE. MAP 3RD FLOOR
Mailing Address - Street 2:MONTEFIORE MEDICAL CENTER, DEPT OF OTHORHINOLARINGOLOGY
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:718-920-4250
Mailing Address - Fax:718-920-8112
Practice Address - Street 1:3400 BAINBRIDGE AVE. MAP 3RD FLOOR
Practice Address - Street 2:MONTEFIORE MEDICAL CENTER, DEPT OF OTORHINOLARYNGOLOGY
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-4250
Practice Address - Fax:718-920-8112
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002301-1231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter