Organization
LDT MEDICAL,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE D THEODORE MD (DIRECTOR)
(631) 960-2544
Entity
Organization
Contact information
Practice address
1 CROSS ISLAND PLZ, ROSEDALE, NY 11422-1465
(718) 525-9800
(718) 525-9801
Mailing address
1 CROSS ISLAND PLZ, ROSEDALE, NY 11422-1465
(718) 525-9800
(718) 525-9801
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
185234
NY
Other
Enumeration date
02/27/2011
Last updated
02/27/2011
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