Individual
ELAINE DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MHS
Contact information
Practice address
6317 4TH AVE, BROOKLYN, NY 11220-4922
(718) 907-8100
Mailing address
6317 4TH AVE, BROOKLYN, NY 11220-4922
(718) 907-8100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
318322
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13-3971298
EMPLOYEE IDENTIFICATION NUMBER
—
Enumeration date
05/15/2019
Last updated
08/24/2022
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