Healthcare Provider Details

I. General information

NPI: 1578508685
Provider Name (Legal Business Name): BORIS LEYBEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 W END AVE APT 1H
NEW YORK NY
10023-5516
US

IV. Provider business mailing address

15 CEDARWOOD LN
SADDLE RIVER NJ
07458-2604
US

V. Phone/Fax

Practice location:
  • Phone: 212-790-6000
  • Fax: 212-962-7770
Mailing address:
  • Phone: 212-790-6000
  • Fax: 212-962-7770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number25MA06439900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number200116-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: