Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 125-55769 | IL |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 290170 | NY |
NPI | 1184850554 |
---|---|
Provider Name | Dr. Leanne Ostrodka |
First Address | Bronx, NY 10467-2403 |
Second Address | Bronx, NY 10467-2403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2009 |
Last Update Date | 05/10/2017 |