Provider Demographics
NPI:1992765028
Name:CESPEDES, LESLIE CARMINA (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:CARMINA
Last Name:CESPEDES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WALT WHITMAN RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3640
Mailing Address - Country:US
Mailing Address - Phone:631-470-4720
Mailing Address - Fax:
Practice Address - Street 1:33 WALT WHITMAN RD STE 240
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-4297
Practice Address - Country:US
Practice Address - Phone:631-470-4720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229149174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI00381Medicare UPIN