Most Relevant Information
Provider Data
| NPI Number: | 1003329715 |
| Provider Name: | INGRID LEACOCK-DANIEL |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 376093 |
Most Important Dates
| Enumeration Date: | 11/16/2017 |
| Last Updated: | 11/16/2017 |
Provider Practice Location
4707 AVENUE K
BROOKLYN
NY
112342111
Practice Location Phone/Fax
| Phone: | 9174463395 |
| Fax: |
Provider Mailing Location
4707 AVENUE K
BROOKLYN
NY
112342111
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |