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General NPI Number Information
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NPI Number | 1992765028
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Entity Type | Individual
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Provider Name | LESLIE CARMINA CESPEDES M.D
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Gender | Female
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 33 WALT WHITMAN RD STE 240
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-4297
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Country | US
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Telephone | 631-470-4720
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Fax |
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Provider Business Mailing Address
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Address Line | 33 WALT WHITMAN RD SUITE 240
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-3640
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Country | US
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Telephone | 631-470-4720
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 229149
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License Number State | NY
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