Provider Demographics
NPI:1124873526
Name:MC GARRELL-HENDRICKS, LEONIE OLINKA (MBBS)
Entity type:Individual
Prefix:MRS
First Name:LEONIE
Middle Name:OLINKA
Last Name:MC GARRELL-HENDRICKS
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:MS
Other - First Name:LEONIE
Other - Middle Name:OLINKA
Other - Last Name:MC GARRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:760 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:646-614-5318
Mailing Address - Fax:
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:646-614-5318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program