Individual
MRS. LESLIEANN LAUREN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
544 BROADWAY, NEWARK, NJ 07104
(973) 318-8316
(973) 318-8317
Mailing address
PO BOX 9506, NEWARK, NJ 07104-0506
(973) 318-8316
(973) 318-8317
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
613612
NY
Other
Enumeration date
10/14/2010
Last updated
08/09/2021
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