Individual
LESLIE BLADES EADON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN BSN AGPCNP-BC OCN
Contact information
Practice address
1275 YORK AVE, M14, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
307448
NY
363LG0600X
Gerontology Nurse Practitioner
307448
NY
363LP2300X
Primary Care Nurse Practitioner
307448
NY
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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