Healthcare Provider Details

I. General information

NPI: 1982922951
Provider Name (Legal Business Name): DELORES SYLVIA MCLEOD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 10/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1371 SEABURY AVE
BRONX NY
10461-3629
US

IV. Provider business mailing address

1371 SEABURY AVE
BRONX NY
10461-3629
US

V. Phone/Fax

Practice location:
  • Phone: 718-294-6200
  • Fax: 718-294-6259
Mailing address:
  • Phone: 718-294-6200
  • Fax: 718-294-6259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF335970
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: