Provider Demographics
NPI:1568257707
Name:LECLERC, EMIE (DPM)
Entity type:Individual
Prefix:
First Name:EMIE
Middle Name:
Last Name:LECLERC
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 BOUL. ROLAND-DURAND
Mailing Address - Street 2:
Mailing Address - City:ROSEMERE
Mailing Address - State:QC
Mailing Address - Zip Code:J7A 4K1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:347-577-4410
Practice Address - Fax:347-677-4596
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program