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Individual

DEBORAH LEONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
29 RIDGE RD, SMITHTOWN, NY 11787-2505
(631) 979-8728
Mailing address
29 RIDGE ROAD, SMITHTOWN, NY 11877-2509
(631) 979-8728

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
008395-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
008395-1
NYS LICENCE P.A.
NY
Enumeration date
02/29/2008
Last updated
02/29/2008
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