Provider Demographics
NPI:1669950093
Name:AKIKOVSKI, LEONORA (FNP)
Entity type:Individual
Prefix:MRS
First Name:LEONORA
Middle Name:
Last Name:AKIKOVSKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:LEONORA
Other - Middle Name:
Other - Last Name:AKIKOVSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:1070 WOODROW RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1112
Mailing Address - Country:US
Mailing Address - Phone:718-967-0681
Mailing Address - Fax:
Practice Address - Street 1:161 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-4441
Practice Address - Country:US
Practice Address - Phone:718-456-9679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-28
Last Update Date:2018-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF342704-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily