Provider Demographics
NPI:1306380704
Name:LEGER, PATRICIA MARIE
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARIE
Last Name:LEGER
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 1:650 BAYCHESTER AVE
Mailing Address - Street 2:ROOM 330
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-1756
Mailing Address - Country:US
Mailing Address - Phone:718-904-5758
Mailing Address - Fax:
Practice Address - Street 1:650 BAYCHESTER AVE
Practice Address - Street 2:ROOM 330
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-1756
Practice Address - Country:US
Practice Address - Phone:718-904-5758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003735-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist