NPI Code Details Logo

NPI 1215739404

NPI 1215739404 : EMILY LEDESMA : CLIFTON, NJ

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1215739404
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    EMILY LEDESMA
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/26/2025
-----------------------------------------------------
    Last Update Date     |    03/26/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    314 MAIN AVE 
-----------------------------------------------------
    City                 |    CLIFTON
-----------------------------------------------------
    State                |    NJ
-----------------------------------------------------
    Zip                  |    07014-1311
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    862-215-3449
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    314 MAIN AVE 
-----------------------------------------------------
    City                 |    CLIFTON
-----------------------------------------------------
    State                |    NJ
-----------------------------------------------------
    Zip                  |    07014-1311
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    862-215-3449
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    171M00000X
-----------------------------------------------------
    Taxonomy Name        |    Case Manager/Care Coordinator
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.