Healthcare Provider Details

I. General information

NPI: 1144142746
Provider Name (Legal Business Name): LESLIE M DEL SALTO DE PENA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 WHISPERING HILLS RD
S PLAINFIELD NJ
07080-5340
US

IV. Provider business mailing address

113 WHISPERING HILLS RD
S PLAINFIELD NJ
07080-5340
US

V. Phone/Fax

Practice location:
  • Phone: 484-350-1166
  • Fax:
Mailing address:
  • Phone: 484-350-1166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number360542
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: