Healthcare Provider Details

I. General information

NPI: 1124609169
Provider Name (Legal Business Name): LEANDRO DAVID SOCOLOVSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

1072 TROY SCHENECTADY RD STE 201
LATHAM NY
12110-1025
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8186
  • Fax: 877-826-5501
Mailing address:
  • Phone: 518-722-3877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMTL2000371
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: