Provider Demographics
NPI:1891060596
Name:BROWN, LEAH ALABANZA (RN)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:ALABANZA
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 227
Mailing Address - Street 2:
Mailing Address - City:PARISH
Mailing Address - State:NY
Mailing Address - Zip Code:13131-0227
Mailing Address - Country:US
Mailing Address - Phone:315-796-0300
Mailing Address - Fax:
Practice Address - Street 1:141 E 111TH ST
Practice Address - Street 2:407
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-2641
Practice Address - Country:US
Practice Address - Phone:212-348-9838
Practice Address - Fax:212-369-8163
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY511601-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool