Individual
MARIO MENDES LEITAO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1275 YORK AVE # H1314, NEW YORK, NY 10065-6007
(212) 639-3987
(212) 717-3709
Mailing address
1275 YORK AVE # H1314, NEW YORK, NY 10065-6007
(646) 620-2438
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
208249
NY
207VX0201X
Gynecologic Oncology Physician
25MA07727200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0043800
—
NJ
Enumeration date
07/04/2006
Last updated
05/29/2024
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