Provider Demographics
NPI:1518228535
Name:KREISMAN, LESLIE (MS, SP ED)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:KREISMAN
Suffix:
Gender:F
Credentials:MS, SP ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5532 NETHERLAND AVE
Mailing Address - Street 2:APT. #1A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2365
Mailing Address - Country:US
Mailing Address - Phone:917-929-4168
Mailing Address - Fax:718-549-1539
Practice Address - Street 1:5532 NETHERLAND AVE
Practice Address - Street 2:APT. #1A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-2365
Practice Address - Country:US
Practice Address - Phone:917-929-4168
Practice Address - Fax:718-549-1539
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY156493861174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist