Individual
LOUIS LEONCE AMBLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MONTAUK HIGHWAY, WEST ISLIP, NY 11795
(631) 376-4027
Mailing address
PO BOX 6010, HAUPPAUGE, NY 11788
(800) 929-3622
(631) 851-9225
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
216663
NY
208D00000X
General Practice Physician
216663-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02279427
—
NY
Enumeration date
03/07/2006
Last updated
10/05/2023
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