Individual
LEONARD T. PASTULA II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
200 BELLE TERRE RD, PORT JEFFERSON, NY 11777-1928
(631) 474-6000
Mailing address
4 CARLISLE DR, GLEN HEAD, NY 11545-2120
(917) 885-2706
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
215143
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02199668
—
NY
01
—
1652Q1
BLUECROSS BLUESHIELD
NY
Enumeration date
03/21/2006
Last updated
03/29/2011
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