Provider Demographics
NPI:1760126031
Name:LESLEY ROTHSCHILD, NURSE PRACTITIONER, PSYCHIATRY P.C.
Entity Type:Organization
Organization Name:LESLEY ROTHSCHILD, NURSE PRACTITIONER, PSYCHIATRY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHSCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:516-491-3175
Mailing Address - Street 1:75 PROSPECT ST STE 207
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3310
Mailing Address - Country:US
Mailing Address - Phone:516-491-3175
Mailing Address - Fax:516-597-5659
Practice Address - Street 1:75 PROSPECT ST STE 207
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3310
Practice Address - Country:US
Practice Address - Phone:516-491-3175
Practice Address - Fax:516-597-5659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-23
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty