Provider Demographics
NPI:1891106381
Name:LEFFINGWELL, DANIEL JAMES SR
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JAMES
Last Name:LEFFINGWELL
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CHAINYK DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-4628
Mailing Address - Country:US
Mailing Address - Phone:518-474-9560
Mailing Address - Fax:518-486-7099
Practice Address - Street 1:52 WASHINGTON STREET ROOM 220N
Practice Address - Street 2:NYS OFFICE OF CHILDREN AND FAMILY SERVICES
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-2796
Practice Address - Country:US
Practice Address - Phone:518-474-9560
Practice Address - Fax:518-486-7099
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309471163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator