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Organization
SOPHIA V. LEONIDA, MD PC
Active
Organization
SOPHIA V. LEONIDA, MD PC
Active
Other names
Stationhouse Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN MELITO (OFFICE MANAGER)
(203) 375-9350
Entity
Organization
Contact information
Practice address
2228 BLACK ROCK TPKE, SUITE 211, FAIRFIELD, CT 06825-3237
(203) 375-9350
(203) 375-8013
Mailing address
2228 BLACK ROCK TPKE, SUITE 211, FAIRFIELD, CT 06825-3237
(203) 375-9350
(203) 375-8013
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
070195
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004267383
—
CT
Enumeration date
07/27/2015
Last updated
07/27/2015
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