Tracey Ann Leona Leard, NPP | |
2640 Pitkin Ave, Brooklyn, NY 11208-2763 | |
(646) 409-9906 | |
Not Available |
Full Name | Tracey Ann Leona Leard |
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Gender | Female |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 2640 Pitkin Ave, Brooklyn, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861711657 | NPI | - | NPPES |
620423 | Other | NY | RN LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 620423 (New York) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | F402015 (New York) | Primary |
Entity Name | Center For Alternative Sentencing And Employment Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932523438 PECOS PAC ID: 2668691189 Enrollment ID: O20140916001425 |
Mailing Address | Practice Location Address |
---|---|
Tracey Ann Leona Leard, NPP 6 Madison Ln, Carle Place, NY 11514-1064 Ph: (646) 409-9906 | Tracey Ann Leona Leard, NPP 2640 Pitkin Ave, Brooklyn, NY 11208-2763 Ph: (646) 409-9906 |
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