Provider Demographics
NPI:1093917718
Name:LE BEL, LEO ALEXIS (CRNA)
Entity Type:Individual
Prefix:MR
First Name:LEO
Middle Name:ALEXIS
Last Name:LE BEL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 ROLLING BROOK LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-5779
Mailing Address - Country:US
Mailing Address - Phone:203-925-9161
Mailing Address - Fax:203-929-6273
Practice Address - Street 1:27 ROLLING BROOK LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:CT
Practice Address - Zip Code:06484-5779
Practice Address - Country:US
Practice Address - Phone:203-925-9161
Practice Address - Fax:203-929-6273
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000299367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000299OtherAPRN