Provider Demographics
NPI:1366176794
Name:MCNEILL, LEONARD III (HEALTH COACH)
Entity type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:
Last Name:MCNEILL
Suffix:III
Gender:M
Credentials:HEALTH COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24114 138TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1713
Mailing Address - Country:US
Mailing Address - Phone:646-960-6551
Mailing Address - Fax:
Practice Address - Street 1:24114 138TH AVE
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-1713
Practice Address - Country:US
Practice Address - Phone:646-960-6551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach