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NPI Code Detail

MEDICARE: ROSALYNN DE LEON

MEDICARE: ROSALYNN DE LEON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner339679NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306204987
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSALYNN DE LEON
Provider Business Mailing Address
First Line : 1797 PITKIN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-7839
Country : US
Telephone Number : 718-971-1944
Fax Number : 718-971-1945
Provider Business Practice Location Address
First Line : 1797 PITKIN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-7839
Country : US
Telephone Number : 718-971-1944
Fax Number : 718-971-1945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2016
Last Update Date : 04/23/2025

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