Provider Demographics
NPI:1386516359
Name:LEAL-JIMENEZ, NORMA CONSTANZA
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:CONSTANZA
Last Name:LEAL-JIMENEZ
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 1:683 DEAN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-3172
Mailing Address - Country:US
Mailing Address - Phone:718-857-2266
Mailing Address - Fax:
Practice Address - Street 1:683 DEAN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-3172
Practice Address - Country:US
Practice Address - Phone:718-857-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty