Provider Demographics
NPI:1609652452
Name:LEONE, RANDI (ATR-BC, LCAT, LPAT)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:LEONE
Suffix:
Gender:F
Credentials:ATR-BC, LCAT, LPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 N MIDDLETOWN RD STE 1D
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1189
Mailing Address - Country:US
Mailing Address - Phone:845-793-2657
Mailing Address - Fax:
Practice Address - Street 1:275 N MIDDLETOWN RD STE 1D
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1189
Practice Address - Country:US
Practice Address - Phone:845-793-2657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001514221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist