Provider Demographics
NPI:1699402313
Name:BAIRD, LEANNA
Entity type:Individual
Prefix:
First Name:LEANNA
Middle Name:
Last Name:BAIRD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 BURRSTONE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-1001
Mailing Address - Country:US
Mailing Address - Phone:315-798-1742
Mailing Address - Fax:315-798-1715
Practice Address - Street 1:4580 STATE HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NY
Practice Address - Zip Code:13807-1147
Practice Address - Country:US
Practice Address - Phone:607-547-3400
Practice Address - Fax:607-547-7662
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349956363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily