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General NPI Number Information
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NPI Number | 1285098483
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Entity Type | Organization
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Legal Business Name | LEON ALEKSANDROVICH MD PC
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 160 BROADWAY SUITE 509
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City | NEW YORK
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State | NY
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Zip | 10038-4201
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Country | US
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Telephone | 212-396-3288
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Fax |
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Provider Business Mailing Address
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Address Line | 160 BROADWAY SUITE 509
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City | NEW YORK
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State | NY
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Zip | 10038-4201
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Country | US
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Telephone | 212-396-3288
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. LEON ALEKSANDROVICH
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Credential | M.D.
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Telephone | 646-789-8951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 245002
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License Number State | NY
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