Provider Demographics
NPI:1609688571
Name:KENNERLY, LEAH LASHAUN
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:LASHAUN
Last Name:KENNERLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 CRANFORD AVE # 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-1307
Mailing Address - Country:US
Mailing Address - Phone:917-891-0176
Mailing Address - Fax:
Practice Address - Street 1:18 KIRBY LN N
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-4208
Practice Address - Country:US
Practice Address - Phone:917-891-0176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No374U00000XNursing Service Related ProvidersHome Health Aide
No376G00000XNursing Service Related ProvidersNursing Home Administrator
No376K00000XNursing Service Related ProvidersNurse's Aide
No385H00000XRespite Care FacilityRespite Care