Healthcare Provider Details

I. General information

NPI: 1528042413
Provider Name (Legal Business Name): LEON STEPENSKY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2005
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 BRIGHTON 2ND ST L2
BROOKLYN NY
11235-7535
US

IV. Provider business mailing address

925 HAMPTON AVE
BROOKLYN NY
11235-3052
US

V. Phone/Fax

Practice location:
  • Phone: 718-332-8633
  • Fax: 718-332-0547
Mailing address:
  • Phone: 718-809-7511
  • Fax: 718-228-8444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN005624
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: