Provider Demographics
NPI:1821599663
Name:LEONARDO, PALOMA M (MSED)
Entity Type:Individual
Prefix:MRS
First Name:PALOMA
Middle Name:M
Last Name:LEONARDO
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 78TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1529
Mailing Address - Country:US
Mailing Address - Phone:917-587-7704
Mailing Address - Fax:
Practice Address - Street 1:2423 78TH ST FL 2
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1529
Practice Address - Country:US
Practice Address - Phone:917-587-7704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency