Provider Demographics
NPI:1386194892
Name:DEFINO, LEORA ANNE
Entity Type:Individual
Prefix:
First Name:LEORA
Middle Name:ANNE
Last Name:DEFINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LEORA
Other - Middle Name:ANNE
Other - Last Name:GIACOIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PL # 3000
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6504
Mailing Address - Country:US
Mailing Address - Phone:212-987-3100
Mailing Address - Fax:212-731-5210
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6504
Practice Address - Country:US
Practice Address - Phone:212-241-6756
Practice Address - Fax:212-423-0522
Is Sole Proprietor?:No
Enumeration Date:2016-10-07
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33-341160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily