Individual
LAUREN M LEADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 229-9290
Mailing address
PO BOX 5807, NEW YORK, NY 10087-5807
(201) 804-2800
(201) 804-8883
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
562333-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
562333-1
RN LICENSE
NY
Enumeration date
01/03/2012
Last updated
11/15/2017
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