Individual
LESLY JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1446 E 103RD ST UNIT 2ND, BROOKLYN, NY 11236-4514
(718) 377-5000
Mailing address
1446 E 103RD ST UNIT 2ND, BROOKLYN, NY 11236-4514
(718) 377-5000
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006633
NY
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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