Provider Demographics
NPI:1730745407
Name:DE LEON, RISHINA (NP-C)
Entity type:Individual
Prefix:
First Name:RISHINA
Middle Name:
Last Name:DE LEON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 BELLEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3600
Mailing Address - Country:US
Mailing Address - Phone:973-748-3800
Mailing Address - Fax:
Practice Address - Street 1:329 BELLEVILLE AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3600
Practice Address - Country:US
Practice Address - Phone:973-748-3800
Practice Address - Fax:973-748-3540
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR15095800363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology