Provider Demographics
NPI:1992072482
Name:ST. LEGER, DANIELLE (DO)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:ST. LEGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:SAINT-LEGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1345 RXR PLZ FL 13
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11556-1301
Mailing Address - Country:US
Mailing Address - Phone:516-453-0435
Mailing Address - Fax:646-846-3283
Practice Address - Street 1:874 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3102
Practice Address - Country:US
Practice Address - Phone:718-571-9372
Practice Address - Fax:718-571-9387
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262654207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine