Individual
LEONID KOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
8811 JAMAICA AVE, WOODHAVEN, NY 11421-2039
(718) 846-2300
Mailing address
8811 JAMAICA AVE, WOODHAVEN, NY 11421-2039
(718) 846-2300
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304465-1
NY
Other
Enumeration date
01/14/2008
Last updated
12/17/2019
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