Gredysa, Leslaw J

Gredysa, Leslaw J is an individual health care provider with primary practice located at 31 Main Rd Suite 2, Riverhead NY 11901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Gredysa, Leslaw J can be contacted via phone (631) 369-8539.

Contact Information

Primary practice address
31 Main Rd Suite 2 Riverhead NY 11901
Phone: (631) 369-8539
Fax: (631) 369-5613
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 175169 New York

Profile Details

NPI number 1184729998
LBN Legal business name Gredysa, Leslaw J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Nov 14th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184729998 NPPES
New York Other 35085 VYTRA
New York MEDICAID 01465594 VYTRA
New York Other 738310 VYTRA

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