Individual
DR. MARIO LECUONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
230 STEUBEN ST, MONTOUR FALLS, NY 14865-9648
(607) 210-1968
(607) 210-1971
Mailing address
230 STEUBEN ST, MONTOUR FALLS, NY 14865-9648
(607) 210-1968
(607) 210-1971
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
103540-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011853200001
—
PA
05
—
00368745
—
NY
01
—
CC8362
RR MEDICARE GROUP
NY
Enumeration date
01/30/2006
Last updated
10/17/2007
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