Provider Demographics
NPI:1851821177
Name:BARABASH, LESLIANNE (MSN, RN, FNP-C)
Entity Type:Individual
Prefix:
First Name:LESLIANNE
Middle Name:
Last Name:BARABASH
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FELIX PL
Mailing Address - Street 2:
Mailing Address - City:AMITY HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11701-4119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 FELIX PL
Practice Address - Street 2:
Practice Address - City:AMITY HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11701-4119
Practice Address - Country:US
Practice Address - Phone:917-371-2543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY341875207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine