Healthcare Provider Details

I. General information

NPI: 1497967079
Provider Name (Legal Business Name): LESLIE R BOYD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E 38TH ST
NEW YORK NY
10016-2708
US

IV. Provider business mailing address

760 BROADWAY WOODHULL MEDICAL & MENTAL HEALTH CENTER DEPARTMENT OF MANAGED CARE ROOM 2B230
BROOKLYN NY
11206
US

V. Phone/Fax

Practice location:
  • Phone: 212-731-6430
  • Fax:
Mailing address:
  • Phone: 718-963-8000
  • Fax: 718-630-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number228120
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number228120
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: