Provider Demographics
NPI:1568693612
Name:LEONARD, MARIE SCAFIDI (MS, CDN)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:SCAFIDI
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MS, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 WARBURTON AVE
Mailing Address - Street 2:# 8P
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1662
Mailing Address - Country:US
Mailing Address - Phone:917-992-9518
Mailing Address - Fax:
Practice Address - Street 1:679 WARBURTON AVE
Practice Address - Street 2:# 8P
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1662
Practice Address - Country:US
Practice Address - Phone:917-992-9518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006158133NN1002X
NY857958133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education