Individual
JILL LEIDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
STONY BROOK UNIVERSITY HOSPITAL, MEDICAL STAFF OFFICE T14, STONY BROOK, NY 11794-7148
(631) 444-2754
(631) 444-6031
Mailing address
STONY BROOK UNIVERSITY HOSPITAL, MEDICAL STAFF OFFICE T14, STONY BROOK, NY 11794-7148
(631) 444-2754
(631) 444-6031
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
054949
NY
Other
Enumeration date
06/11/2009
Last updated
12/06/2010
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