Individual
JACQUELINE IRENE DE LEON DY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
8449 168TH ST, UNIT 6A, JAMAICA, NY 11432-2048
(718) 880-6697
Mailing address
8449 168TH ST, UNIT 6A, JAMAICA, NY 11432-2048
(718) 880-6697
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303931
NY
Other
Enumeration date
08/11/2005
Last updated
11/20/2019
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