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General NPI Number Information
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NPI Number | 1568976454
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Entity Type | Individual
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Provider Name | JOHN JOSEPH LEON
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Gender | Male
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Dates
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Enumeration Date | 11/30/2017
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Last Update Date | 12/05/2017
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Provider Practice Location Address
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Address Line | 2024 WILLIAMSBRIDGE RD STE 3
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City | BRONX
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State | NY
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Zip | 10461-1631
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Country | US
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Telephone | 917-992-1569
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Fax | 718-329-0267
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Provider Business Mailing Address
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Address Line | 254 MARTINE AVE APT 2D
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City | WHITE PLAINS
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State | NY
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Zip | 10601-3426
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Country | US
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Telephone | 512-825-7352
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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