# LEIDA MEDINA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093052227
- **Authorized official:** DR. LEIDA MEDINA MD (PRESIDENT)
- **Authorized official phone:** (516) 676-1160

## Contact information

- **Practice address:** 3 SCHOOL ST, SUITE 301, GLEN COVE, NY 11542-2590
- **Practice address phone:** (516) 676-1160
- **Practice address fax:** (516) 671-5231
- **Mailing address:** 3 SCHOOL ST, SUITE 301, GLEN COVE, NY 11542-2590
- **Mailing address phone:** (516) 676-1160
- **Mailing address fax:** (516) 671-5231

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2013
- **Last updated:** 03/16/2015