Provider Demographics
NPI:1689909020
Name:LEACH-MINAZZI, DANIELLE MARGARET (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARGARET
Last Name:LEACH-MINAZZI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 FRANK AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14210-1931
Mailing Address - Country:US
Mailing Address - Phone:716-563-8191
Mailing Address - Fax:
Practice Address - Street 1:227 RIDGE RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14218-1156
Practice Address - Country:US
Practice Address - Phone:716-822-5944
Practice Address - Fax:716-822-3937
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335624-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily