Healthcare Provider Details

I. General information

NPI: 1437167814
Provider Name (Legal Business Name): LEON NEIMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 W MARKET ST STE 3
FAIRLAWN OH
44333-2663
US

IV. Provider business mailing address

3500 W MARKET ST STE 3
FAIRLAWN OH
44333-2663
US

V. Phone/Fax

Practice location:
  • Phone: 330-535-3101
  • Fax: 330-535-2411
Mailing address:
  • Phone: 330-535-3101
  • Fax: 330-535-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35023595
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number35023595
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: