Individual
DR. LEO J GOSSELIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1571 WASHINGTON ST, SUITE 201, WATERTOWN, NY 13601-9304
(315) 782-1650
(315) 788-8547
Mailing address
1571 WASHINGTON ST, SUITE 201, WATERTOWN, NY 13601-9304
(315) 782-1650
(315) 788-8547
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
216822
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02060373
—
NY
Enumeration date
11/25/2005
Last updated
10/11/2007
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