Provider Demographics
NPI:1255666525
Name:ALTIERI, LESLIE A (CFNP)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:A
Last Name:ALTIERI
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:MOODY
Mailing Address - State:ME
Mailing Address - Zip Code:04054-0425
Mailing Address - Country:US
Mailing Address - Phone:207-251-4362
Mailing Address - Fax:
Practice Address - Street 1:75 STOCKWELL DR
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:MA
Practice Address - Zip Code:02322-1170
Practice Address - Country:US
Practice Address - Phone:508-427-3900
Practice Address - Fax:508-427-3930
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA142213363LF0000X, 363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health