MEDICARE: DR. AMY R LEONARD M.D.

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	208000000X	Pediatrics Physician	239945	NY

General Provider Information

NPI Number	:	1508971151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY R LEONARD M.D.

Provider Business Mailing Address
First Line	:	239 BOYLE RD
Second Line	:	SUITE 7
City	:	SELDEN
State	:	NY
Zip	:	11784-1955
Country	:	US
Telephone Number	:	631-698-0600
Fax Number	:	631-698-2212

Provider Business Practice Location Address
First Line	:	239 BOYLE RD
Second Line	:	SUITE 7
City	:	SELDEN
State	:	NY
Zip	:	11784-1955
Country	:	US
Telephone Number	:	631-698-0600
Fax Number	:	631-698-2212

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	07/08/2007

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