Provider Demographics
NPI:1356603104
Name:ABRAHAMS, LEILA M (LPN)
Entity type:Individual
Prefix:
First Name:LEILA
Middle Name:M
Last Name:ABRAHAMS
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 1:711 HARTMAN LN
Mailing Address - Street 2:APT. 2
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-1850
Mailing Address - Country:US
Mailing Address - Phone:347-246-7529
Mailing Address - Fax:347-246-7529
Practice Address - Street 1:711 HARTMAN LN
Practice Address - Street 2:APT. 2
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-1850
Practice Address - Country:US
Practice Address - Phone:347-246-7529
Practice Address - Fax:347-246-7529
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216876-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse