TDL Medical,PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

TDL MEDICAL,PC

Practice address

2546 E 17TH St
Brooklyn, NY 11235-3516

Phone

(718) 368-0300

Fax

(718) 368-0301

NPI assigned

Mar 1, 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

President

Phone

(631) 960-2544

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298937600000",
    "number": "1922306901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 E 17TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353516",
            "telephone_number": "718-368-0300",
            "fax_number": "718-368-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546 E 17TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353516",
            "telephone_number": "718-368-0300",
            "fax_number": "718-368-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDL MEDICAL,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-01",
        "last_updated": "2011-03-01",
        "status": "A",
        "authorized_official_last_name": "THEODORE",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-960-2544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Health Service Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.