Provider Demographics
NPI:1225334899
Name:LEVEILLE, LEE OLIVE
Entity Type:Individual
Prefix:MRS
First Name:LEE
Middle Name:OLIVE
Last Name:LEVEILLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 LINCOLN RD
Mailing Address - Street 2:APT 4A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-4077
Mailing Address - Country:US
Mailing Address - Phone:347-299-3355
Mailing Address - Fax:
Practice Address - Street 1:115 LINCOLN RD
Practice Address - Street 2:APT 4A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-4077
Practice Address - Country:US
Practice Address - Phone:347-299-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY543388163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse