Provider Demographics
NPI:1518506674
Name:LEONARDO, LENY TANIAJURA
Entity Type:Individual
Prefix:
First Name:LENY
Middle Name:TANIAJURA
Last Name:LEONARDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14638 56TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5407
Mailing Address - Country:US
Mailing Address - Phone:347-468-6977
Mailing Address - Fax:
Practice Address - Street 1:14638 56TH RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5407
Practice Address - Country:US
Practice Address - Phone:347-468-6977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program