Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 141102 | NY |
NPI | 1376603498 |
---|---|
Provider Name | Mary Leong |
First Address | New Hyde Park, NY 11040 |
Second Address | New Hyde Park, NY 11040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 07/03/2008 |