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General NPI Number Information
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NPI Number | 1477002087
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Entity Type | Individual
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Provider Name | MARY LEDO LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 1841 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10035
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Country | US
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Telephone | 917-715-0651
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Fax |
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Provider Business Mailing Address
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Address Line | 145 W 96TH STREET APT 15A
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City | NEW YORK
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State | NY
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Zip | 10025
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Country | US
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Telephone | 646-272-8122
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 089849
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 72-098804
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License Number State | NY
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