Individual
LEEZA PANTANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
131 GAULDY AVE, STATEN ISLAND, NY 10314-7240
(917) 376-7474
Mailing address
131 GAULDY AVE, STATEN ISLAND, NY 10314-7240
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1997344261
NY
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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