Provider Demographics
NPI:1639476740
Name:KLAIBER, LETICIA S (RN)
Entity Type:Individual
Prefix:MISS
First Name:LETICIA
Middle Name:S
Last Name:KLAIBER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 E 137TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-4004
Mailing Address - Country:US
Mailing Address - Phone:718-993-3458
Mailing Address - Fax:718-993-3948
Practice Address - Street 1:408 E 137TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-4004
Practice Address - Country:US
Practice Address - Phone:718-993-3458
Practice Address - Fax:718-993-3948
Is Sole Proprietor?:No
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY634876163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse