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General NPI Number Information
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NPI Number | 1124166814
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Entity Type | Organization
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Legal Business Name | LEONID TIMASHPOLSKY PHYSICIAN, P.C.
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 97-85 QUEENS BLVD
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City | REGO PARK
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State | NY
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Zip | 11374-3319
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Country | US
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Telephone | 718-261-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 107 ELINOR RD
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City | NEWTON
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State | MA
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Zip | 02461-1848
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Country | US
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Telephone | 617-332-3329
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Fax |
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Authorized Official
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Title or Position | OWNER OF CORPORATION
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Name | DR. LEONID TIMASHPOLSKY
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Credential | M.D.
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Telephone | 617-332-3329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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