Provider Demographics
NPI:1578617742
Name:CURTIS, LESLY JO (NP)
Entity Type:Individual
Prefix:MS
First Name:LESLY
Middle Name:JO
Last Name:CURTIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 W 85TH ST
Mailing Address - Street 2:APT 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3244
Mailing Address - Country:US
Mailing Address - Phone:212-873-8861
Mailing Address - Fax:212-873-8861
Practice Address - Street 1:252 W 85TH ST
Practice Address - Street 2:APT 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3244
Practice Address - Country:US
Practice Address - Phone:212-873-8861
Practice Address - Fax:212-873-8861
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400577363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner