Provider Demographics
NPI:1013723600
Name:WASIELEWSKI, AIDIL
Entity type:Individual
Prefix:
First Name:AIDIL
Middle Name:
Last Name:WASIELEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AIDIL
Other - Middle Name:MIGUELINA
Other - Last Name:DE LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:755 ELTON AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5655
Mailing Address - Country:US
Mailing Address - Phone:239-216-3668
Mailing Address - Fax:
Practice Address - Street 1:755 ELTON AVE APT 3
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5655
Practice Address - Country:US
Practice Address - Phone:347-491-3798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency