MEDICARE: DR. LEONID E. TAFLER

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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	212382	NY
2	207Q00000X	Family Medicine Physician	212382	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932237146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONID E. TAFLER

Provider Business Mailing Address
First Line	:	4010 AVENUE J
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4440
Country	:	US
Telephone Number	:	718-338-1166
Fax Number	:	718-951-7550

Provider Business Practice Location Address
First Line	:	4010 AVENUE J
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4440
Country	:	US
Telephone Number	:	718-338-1166
Fax Number	:	718-951-7550

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	09/17/2015

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