Basic Information
Provider Information
NPI: 1942247390
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HLEAP
FirstName: CARLOS
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 ZECKENDORF BLVD
Address2:  
City: GARDEN CITY
State: NY
PostalCode: 115302133
CountryCode: US
TelephoneNumber: 5165426880
FaxNumber: 5165425556
Practice Location
Address1: 3175 23RD ST
Address2:  
City: ASTORIA
State: NY
PostalCode: 111064134
CountryCode: US
TelephoneNumber: 7189562200
FaxNumber: 7189562316
Other Information
ProviderEnumerationDate: 06/02/2006
LastUpdateDate: 10/05/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X184835NYY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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