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Individual

LEA RACKIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1776 CLAY AVE, BRONX, NY 10457-7239
(718) 299-1100
(718) 716-7822
Mailing address
54 ALLISON WAY, EMERSON, NJ 07630-1829
(201) 261-4395

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
165668
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01822568
NY
Enumeration date
06/28/2006
Last updated
07/08/2007
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