Healthcare Provider Details

I. General information

NPI: 1811131345
Provider Name (Legal Business Name): LEO URBINELLI M.D., M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 HERITAGE LANDING DR STE B
EAST SYRACUSE NY
13057-9378
US

IV. Provider business mailing address

5800 HERITAGE LANDING DR STE B
EAST SYRACUSE NY
13057-9378
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-0158
  • Fax: 315-565-2258
Mailing address:
  • Phone: 315-464-0158
  • Fax: 315-565-2258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number268935
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: