Provider Demographics
NPI:1457765240
Name:LEONARD, DOROTHY ANNE (CNA)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:ANNE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CANDLE LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-2501
Mailing Address - Country:US
Mailing Address - Phone:516-724-5043
Mailing Address - Fax:516-513-0396
Practice Address - Street 1:21 CANDLE LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-2501
Practice Address - Country:US
Practice Address - Phone:516-724-5043
Practice Address - Fax:516-513-0396
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342711250708E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide