Provider Demographics
NPI:1194185959
Name:LESLIE, CHERYL (RDN)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:LESLIE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 E POST RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4607
Mailing Address - Country:US
Mailing Address - Phone:914-681-2010
Mailing Address - Fax:914-681-2839
Practice Address - Street 1:2 LONGVIEW AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-5000
Practice Address - Country:US
Practice Address - Phone:914-681-1210
Practice Address - Fax:914-681-2839
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008014133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered