Individual
DOROTHY LEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21111 NORTHERN BLVD, BAYSIDE, NY 11361-3241
(212) 273-6272
Mailing address
626 VILLAGE GRN N, PORT WASHINGTON, NY 11050-4717
(516) 205-3990
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
340306
NY
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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