Healthcare Provider Details

I. General information

NPI: 1568773141
Provider Name (Legal Business Name): BRIAN P LEYH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2010
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 MARYS AVE STE 102
KINGSTON NY
12401-5849
US

IV. Provider business mailing address

1 ATWELL RD
COOPERSTOWN NY
13326-1301
US

V. Phone/Fax

Practice location:
  • Phone: 914-789-2700
  • Fax:
Mailing address:
  • Phone: 706-547-3334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number272361
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: