Individual
LEONID GLADSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
409 COMMACK RD STE 2B, DEER PARK, NY 11729-4508
(917) 887-8872
Mailing address
409 COMMACK RD STE 2B, DEER PARK, NY 11729-4508
(917) 887-8872
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006983
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006983
—
NY
Enumeration date
05/29/2018
Last updated
05/29/2018
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