Provider Demographics
NPI:1881020642
Name:KATOS, LEIGHANN G (LPN)
Entity Type:Individual
Prefix:
First Name:LEIGHANN
Middle Name:G
Last Name:KATOS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 NASSAU ST
Mailing Address - Street 2:
Mailing Address - City:ISLIP TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11752-2708
Mailing Address - Country:US
Mailing Address - Phone:631-946-9231
Mailing Address - Fax:
Practice Address - Street 1:4 NASSAU ST
Practice Address - Street 2:
Practice Address - City:ISLIP TERRACE
Practice Address - State:NY
Practice Address - Zip Code:11752-2708
Practice Address - Country:US
Practice Address - Phone:631-946-9231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302844164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse