Individual
GABRIELLA T LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.N.P.
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3909
(607) 547-6325
Mailing address
PO BOX 725, COOPERSTOWN, NY 13326-0725
(607) 547-3909
(607) 547-6325
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F380130
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02315460
—
NY
Enumeration date
06/05/2006
Last updated
07/08/2007
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