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General NPI Number Information
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NPI Number | 1194766659
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Entity Type | Individual
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Provider Name | GLENN TAYLOR LEONARD JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 936 DELAWARE AVE SUITE 100
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City | BUFFALO
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State | NY
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Zip | 14209-1804
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Country | US
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Telephone | 716-885-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 6313 EVERWOOD CT S
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City | EAST AMHERST
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State | NY
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Zip | 14051-2031
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Country | US
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Telephone | 716-713-8057
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 200400902
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | ME80507
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 240624
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 240624-1
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License Number State | NY
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