Healthcare Provider Details

I. General information

NPI: 1881998581
Provider Name (Legal Business Name): MRS. LESLY ESCOBAR-TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 CONEY ISLAND AVE
BROOKLYN NY
11223-2329
US

IV. Provider business mailing address

2020 CONEY ISLAND AVE
BROOKLYN NY
11223-2329
US

V. Phone/Fax

Practice location:
  • Phone: 718-676-4280
  • Fax:
Mailing address:
  • Phone: 718-676-4280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: