Individual
DIANA LENIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 SMITH HAVEN MALL, SUITE 203, LAKE GROVE, NY 11755-0001
(631) 444-0580
Mailing address
4 SMITH HAVEN MALL, SUITE 203, LAKE GROVE, NY 11755-2508
(631) 444-0580
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
316755
NY
Other
Enumeration date
04/02/2019
Last updated
03/26/2025
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