Provider Demographics
NPI:1518218429
Name:SPECIALE, LEAH DANIELLE (RN, BSN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:DANIELLE
Last Name:SPECIALE
Suffix:
Gender:F
Credentials:RN, BSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3670 S BENZING RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1737
Mailing Address - Country:US
Mailing Address - Phone:716-310-4284
Mailing Address - Fax:
Practice Address - Street 1:3680 EGGERT RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1963
Practice Address - Country:US
Practice Address - Phone:716-662-5357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337497-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily