Individual
LESLIE CORTEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
5225 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2053
(631) 473-4284
Mailing address
5225 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2053
(631) 473-4284
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-3139640
SERVICE COORDINATOR
NY
Enumeration date
11/09/2015
Last updated
11/09/2015
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