Provider Demographics
NPI:1750853750
Name:LEONCE, ALEXANDER BRANDON (RN)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:BRANDON
Last Name:LEONCE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:ROOSEVELT
Mailing Address - State:NY
Mailing Address - Zip Code:11575-2217
Mailing Address - Country:US
Mailing Address - Phone:516-362-9504
Mailing Address - Fax:
Practice Address - Street 1:64 GRANT ST
Practice Address - Street 2:
Practice Address - City:ROOSEVELT
Practice Address - State:NY
Practice Address - Zip Code:11575-2217
Practice Address - Country:US
Practice Address - Phone:516-362-9504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY758880163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health