Provider Demographics
NPI:1811675382
Name:LEDUC, DINA (NP)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:LEDUC
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 POWELL AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3412
Mailing Address - Country:US
Mailing Address - Phone:845-569-3152
Mailing Address - Fax:845-569-3514
Practice Address - Street 1:330 POWELL AVE
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3412
Practice Address - Country:US
Practice Address - Phone:845-569-3152
Practice Address - Fax:845-569-3514
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF311356-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health