MEDICARE: MR. LEONID TALYANSKY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	0858750001	NY

General Provider Information

NPI Number	:	1437251840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LEONID TALYANSKY

Provider Business Mailing Address
First Line	:	1212 AVE. U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229
Country	:	US
Telephone Number	:	718-382-6409
Fax Number	:	718-376-1422

Provider Business Practice Location Address
First Line	:	1212 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4107
Country	:	US
Telephone Number	:	718-382-6409
Fax Number	:	718-376-1422

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	10/10/2007

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