Individual
DR. JOSE RAFAEL DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
143 ESSEX ST, NEW YORK, NY 10002-2336
(212) 228-2999
(212) 228-3323
Mailing address
60 E CARPENTER ST, VALLEY STREAM, NY 11580-4404
(516) 561-9459
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046096
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01588090
—
NY
Enumeration date
10/28/2005
Last updated
02/15/2012
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