Provider Demographics
NPI:1588487110
Name:LABORIEL, LESLIE R (MBA)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:R
Last Name:LABORIEL
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-1845
Mailing Address - Country:US
Mailing Address - Phone:845-825-2715
Mailing Address - Fax:
Practice Address - Street 1:158 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-1845
Practice Address - Country:US
Practice Address - Phone:845-825-2715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty