Provider Demographics
NPI:1114239167
Name:LEANO, REMILEE ESCARILLA (RPT)
Entity Type:Individual
Prefix:MS
First Name:REMILEE
Middle Name:ESCARILLA
Last Name:LEANO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MS
Other - First Name:REMILEE
Other - Middle Name:ESCARILLA
Other - Last Name:LEANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:215 MOSELY AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-4165
Mailing Address - Country:US
Mailing Address - Phone:718-227-0293
Mailing Address - Fax:
Practice Address - Street 1:215 MOSELY AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-4165
Practice Address - Country:US
Practice Address - Phone:718-227-0293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02407225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist