LDT Medical,PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

185234 Issued in NY

Legal business name

LDT MEDICAL,PC

Practice address

1 Cross Island PLZ
Rosedale, NY 11422-1465

Phone

(718) 525-9800

Fax

(718) 525-9801

NPI assigned

Feb 27, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Leslie D Theodore, MD

Title

Director

Phone

(631) 960-2544

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298764800000",
    "number": "1801193875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CROSS ISLAND PLZ",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114221465",
            "telephone_number": "718-525-9800",
            "fax_number": "718-525-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CROSS ISLAND PLZ",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114221465",
            "telephone_number": "718-525-9800",
            "fax_number": "718-525-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDT MEDICAL,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-27",
        "last_updated": "2011-02-27",
        "status": "A",
        "authorized_official_last_name": "THEODORE",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-960-2544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "185234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margareth M. Lafontant, M.S.E., A.B.D.
• Claudette Laguerre
• Nicole T Lampkin
• Venice Lane
• Towanna Lawson, LPN
• Christela Leandre
• Edith Delores Ledford, LPN
• Dina Tzipora Leff
• Camille Lennon, LPN
• Life'S Worc

• Clinic/Center in Rosedale, NY
• Providers in Rosedale, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.