Individual
MRS. LEYLA C ESCUDERO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
40-33 76TH ST, SUITE NO 4D, ELMHURST, NY 11373
(718) 458-7426
(718) 672-5591
Mailing address
37-10 76TH ST, APT 4D, JACKSON HEIGHTS, NY 11372
(718) 458-0361
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
043063
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01239261
—
NY
01
—
02303
GUARDIAN
NY
01
—
9177351
DORAL
NY
Enumeration date
11/09/2005
Last updated
07/08/2007
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