| Ldt Medical,pc | |
|
1 Cross Island Plz Rosedale NY 11422-1465 | |
| (718) 525-9800 | |
| (718) 525-9801 |
| Full Name | Ldt Medical,pc |
|---|---|
| Speciality | Clinic/center |
| Location | 1 Cross Island Plz, Rosedale, New York |
| Authorized Official Name and Position | Leslie D Theodore (DIRECTOR) |
| Authorized Official Contact | 6319602544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ldt Medical,pc 1 Cross Island Plz Rosedale NY 11422-1465 Ph: (718) 525-9800 | Ldt Medical,pc 1 Cross Island Plz Rosedale NY 11422-1465 Ph: (718) 525-9800 |
| NPI Number | 1801193875 |
|---|---|
| Provider Enumeration Date | 02/27/2011 |
| Last Update Date | 02/27/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801193875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 185234 (New York) | Primary |
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