Provider Demographics
NPI:1801381314
Name:ROTHSCHILD, LESLEY (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:ROTHSCHILD
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402427363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health