Provider Demographics
NPI:1528890423
Name:LESANTI, DEANDRA (BSN RN)
Entity type:Individual
Prefix:
First Name:DEANDRA
Middle Name:
Last Name:LESANTI
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 GREGORY DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1058
Mailing Address - Country:US
Mailing Address - Phone:716-361-4462
Mailing Address - Fax:
Practice Address - Street 1:291 ELM ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1621
Practice Address - Country:US
Practice Address - Phone:716-854-2444
Practice Address - Fax:716-854-4671
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY829172163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)