Individual
NILDA M LEON-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
374 GRAND AVE, FAIR HAVEN COMMUNITY HEALTH CTR, NEW HAVEN, CT 06513
(203) 777-7411
(203) 777-8506
Mailing address
93 AUTUMN RIDGE, TRUMBALL, CT 06611
(203) 445-1077
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
035885
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A235763
—
CT
01
—
010035885CT01
ANTHEM BCBS
—
01
—
035885 9734
CONNECTICARE
—
01
—
P2742383
OXFORD
—
Enumeration date
09/01/2006
Last updated
07/08/2007
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