Healthcare Provider Details

I. General information

NPI: 1144139759
Provider Name (Legal Business Name): LESLYE SOLEDAD DEL CARPIO GOMEZ LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 AKRON ST
COPIAGUE NY
11726-2931
US

IV. Provider business mailing address

1 ROUTE 109
WEST BABYLON NY
11704-6207
US

V. Phone/Fax

Practice location:
  • Phone: 631-552-4240
  • Fax:
Mailing address:
  • Phone: 631-552-4240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number357121
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: