Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MT197886 | PA |
N | 208600000X | Surgeon | MT197886 | PA |
N | 2086S0102X | Surgical Critical Care | 289161 | NY |
N | 2086S0102X | Surgical Critical Care | MD455147 | PA |
Y | 2086S0127X | Trauma Surgeon | 289161 | NY |
N | 2086S0127X | Trauma Surgeon | MD455147 | PA |
NPI | 1144535725 |
---|---|
Provider Name | Leandra Krowsoski |
First Address | Valhalla, NY 10595-1530 |
Second Address | Valhalla, NY 10595-1530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2010 |
Last Update Date | 17/03/2018 |