Individual
LESLIE J PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSNP
Contact information
Practice address
1212 ROUTE 25A, STONY BROOK, NY 11790-3105
(631) 751-2892
(631) 751-4148
Mailing address
1212 ROUTE 25A, STONY BROOK, NY 11790-3105
(631) 751-2892
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
203396
NY
363L00000X
Nurse Practitioner
265410
NY
363L00000X
Nurse Practitioner
Primary
F4000881
NY
Other
Enumeration date
11/07/2006
Last updated
03/04/2015
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