Individual
LEONNE TANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, WHNP
Contact information
Practice address
439 PORT RICHMOND AVE, STATEN ISLAND, NY 10302-1714
(718) 876-1732
Mailing address
69 FOREST ST, MONTCLAIR, NJ 07042-3810
(718) 594-0366
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
F002225
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F002225
NEW YORK STATE
NY
Enumeration date
05/03/2022
Last updated
12/05/2024
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