Provider Demographics
NPI:1508002056
Name:JEANNITON, LESLIE MARIE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:MARIE
Last Name:JEANNITON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:LESLIE
Other - Middle Name:MARIE
Other - Last Name:JEANNITON-TORBATI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:172 NOYE LANE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598
Mailing Address - Country:US
Mailing Address - Phone:516-220-7776
Mailing Address - Fax:516-374-7477
Practice Address - Street 1:571 MCDONALD AVE.
Practice Address - Street 2:YELED V' YALDA
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218
Practice Address - Country:US
Practice Address - Phone:718-686-3700
Practice Address - Fax:718-436-8851
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009516-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist