Organization
TDL MEDICAL,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE D THEODORE MD (PRESIDENT)
(631) 960-2544
Entity
Organization
Contact information
Practice address
2546 E 17TH ST, BROOKLYN, NY 11235-3516
(718) 368-0300
(718) 368-0301
Mailing address
2546 E 17TH ST, BROOKLYN, NY 11235-3516
(718) 368-0300
(718) 368-0301
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
03/01/2011
Last updated
03/01/2011
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