Individual
EVANGELINE DE LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
163 W 125TH ST, NEW YORK, NY 10027-4436
(212) 961-8743
Mailing address
163 W 125TH ST, NEW YORK, NY 10027-4436
(212) 961-8743
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
612513
NY
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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