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General NPI Number Information
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NPI Number | 1801893367
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Entity Type | Individual
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Provider Name | POLLY E LEONARD D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 390 TOLLGATE ROAD SUITE 203
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City | WARWICK
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State | RI
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Zip | 02886
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Country | US
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Telephone | 401-732-2031
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Fax | 888-948-3254
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Provider Business Mailing Address
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Address Line | 390 TOLL GATE RD STE 203
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City | WARWICK
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State | RI
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Zip | 02886-4326
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Country | US
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Telephone | 401-732-2031
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Fax | 888-948-3254
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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 | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | DO00496
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO00496
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License Number State | RI
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