Provider Demographics
NPI:1598017238
Name:LEANDRE, CHRISTELA
Entity Type:Individual
Prefix:MS
First Name:CHRISTELA
Middle Name:
Last Name:LEANDRE
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 1:12854 235TH ST
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1033
Mailing Address - Country:US
Mailing Address - Phone:347-613-2319
Mailing Address - Fax:
Practice Address - Street 1:12854 235TH ST
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-1033
Practice Address - Country:US
Practice Address - Phone:347-613-2319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist