Ldt Medical,pc

NPI #1801193875 in Rosedale, New York

Provider Information

NPI Number: 1801193875
Entity Type: Organization
Organization Name: Ldt Medical,pc
Primary Specialty: Clinic/Center
Enumeration Date: Feb 27, 2011
Last Updated: Feb 27, 2011

Practice Location

Address: 1 CROSS ISLAND PLZ
City: Rosedale
State: New York
ZIP Code: 11422-1465
Phone: (718) 525-9800

Authorized Official

Name: DR. LESLIE D THEODORE, MD
Title: DIRECTOR
Phone: (631) 960-2544

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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