Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 402911 | NY |
NPI | 1003447723 |
---|---|
Provider Name | Leah Molina |
First Address | Cheektowaga, NY 14225-4965 |
Second Address | Cheektowaga, NY 14225-1422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2020 |
Last Update Date | 09/01/2021 |