GLORIA DUNNDER LEACOCK (NPI# 1619040607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619040607 |
| Entity Type | Individual |
| Full Name | GLORIA DUNNDER LEACOCK |
| Credential | MD |
| Practice Address |
3096 51st St Woodside NY 11377-1457 |
| Mailing Address |
440 E 20th St Apt 9b New York NY 10009-8213 |
| Practice Telephone | 7182041469 |
| Practice Fax Number | 7185451726 |
| Mailing Telephone | 2125452400 |
| Mailing Fax Number | 6463120481 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2016-06-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 204175 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00695941 | 05 |
| Street Address |
3096 51ST ST |
| City | WOODSIDE |
| State | NY |
| Zip Code | 11377-1457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811513005 | Constance H Kim | Physician Assistant | 3096 51st St, Woodside, NY 11377-1457 | 2020-06-23 |
| 1750622239 | Dunn-lea Medical PC | Family Medicine | 3096 51st St, Woodside, NY 11377-1457 | 2013-03-08 |
| 1427285121 | Jean Langhans, Np, PC | Nurse Practitioner | 3096 51st St, Woodside, NY 11377-1457 | 2009-06-19 |
| 1346385069 | Altagrace Belmar | Pediatrics | 3096 51st St, Woodside, NY 11377-1457 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353738 | Qw Pharmacy Inc | Pharmacy | 54-03 Roosevelt Ave., Woodside, NY 11377 | 2020-07-10 |
| 1689214348 | Reilly Abbott | Social Worker | 42-77 65th Pl, Woodside, NY 11377 | 2020-01-10 |
| 1134767833 | Queens Boulevard Chiropractic P.C. | Chiropractor | 51-27 Queens Blvd, 2nd Fl 2c, Woodside, NY 11377 | 2019-12-13 |
| 1497313399 | Aftab Ahmed | Pharmacist | 5801 Woodside Ave # 3, Woodside, NY 11377 | 2019-06-05 |
| 1780240606 | Simple Therapy Pt PC | Clinic/Center | 49-03 69th Street, Unit B, Woodside, NY 11377 | 2019-05-15 |
| 1386115046 | Andrea Charidemou | Social Worker | 42-77 62nd Pl, Woodside, NY 11377 | 2018-12-06 |
| 1952870198 | American United Medicine PC | Allergy & Immunology | 5314 Roosevelt Ave., Ste 302, Rm 5, Woodside, NY 11377 | 2018-11-16 |
| 1396226999 | Michelle Xian | Social Worker | 42-77 65th Pl., Woodside, NY 11377 | 2018-08-22 |
| 1598253759 | Noel Melon Nuevas | Physical Therapy Assistant | 63 08 39th Ave, Woodside, NY 11377 | 2018-04-24 |
| 1992206585 | Sixtieth Family Dental,pllc | Clinic/Center | 6019 Roosevelt Ave Ste 225, Woodside, NY 11377 | 2018-02-28 |
| Find all providers in zip 11377 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881965804 | Queens Medical South PC | Family Medicine | 3939 63rd St, Woodside, NY 11377-3648 | 2012-01-23 |
| 1922241397 | Mark I Congress | Family Medicine | 45 Roberta Drive, Woodside, CA 94062 | 2009-04-14 |
| 1124205570 | Woodside Medical Care P.c | Family Medicine | 6019 Roosevelt Ave. 201, Woodside, NY 11377-3537 | 2008-01-29 |
| 1831239391 | Daniel Do Young Park | Family Medicine | 6019 Roosevelt Ave, Suite #201, Woodside, NY 11377-3537 | 2007-02-07 |
| 1619013463 | Saulius J Skeivys | Family Medicine | 5718 Woodside Avenue, Woodside, NY 11377-3444 | 2007-01-29 |
| 1063570018 | Joseph A Zammuto | Family Medicine | 213 Crest Rd, Woodside, CA 94062-2310 | 2006-12-04 |
| 1508874819 | Alexander V. Baldonado | Family Medicine | 6317 Roosevelt Ave, Woodside, NY 11377-3641 | 2006-08-03 |
| 1205889201 | Mirela Carnaru | Family Medicine | 5025 65th St, Woodside, NY 11377-5810 | 2006-05-18 |
| 1447864764 | Aka Medical Wellness and Aesthetics LLC | Family Medicine | 5801 Woodside Ave, Woodside, NY 11377-3437 | 2020-09-03 |
| 1497245187 | Joseph A Zammuto | Family Medicine | 213 Crest Rd, Woodside, CA 94062 | 2018-05-17 |
| Find all providers in WOODSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.