Dunnder Leacock, Gloria
Dunnder Leacock, Gloria is an sole proprietor health care provider with primary practice located at 3096 51St St , Woodside NY 11377-1457. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Dunnder Leacock, Gloria can be contacted via phone (718) 204-1469.Contact Information
Primary practice address
3096 51St St
Woodside NY 11377-1457
Phone: (718) 204-1469
Fax: (718) 545-1726
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 204175 | New York |
Profile Details
| NPI number | 1619040607 |
|---|---|
| LBN Legal business name | Dunnder Leacock, Gloria |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 16th, 2006 |
| Last updated | Jun 24th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619040607 | NPPES |
| New York | MEDICAID | 00695941 |
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