Provider Demographics
NPI:1518232503
Name:GERMAIN, LEISA (RN)
Entity Type:Individual
Prefix:MS
First Name:LEISA
Middle Name:
Last Name:GERMAIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:978 E 89TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3911
Mailing Address - Country:US
Mailing Address - Phone:718-927-4153
Mailing Address - Fax:
Practice Address - Street 1:1001 E 100TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4415
Practice Address - Country:US
Practice Address - Phone:718-251-0185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY466473-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse