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NPI Code Detail

MEDICARE: JEFFREY S LEEN MD

MEDICARE: JEFFREY S LEEN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician25MA07527700NJ
2207WX0110XPediatric Ophthalmology and Strabismus Specialist Physician Physician228130NY
3207W00000XOphthalmology Physician228130NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063496834
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY S LEEN MD
Provider Business Mailing Address
First Line : 171 RAMAPO RD
Second Line :
City : GARNERVILLE
State : NY
Zip : 10923-1552
Country : US
Telephone Number : 845-947-2240
Fax Number : 845-947-2265
Provider Business Practice Location Address
First Line : 171 RAMAPO RD
Second Line :
City : GARNERVILLE
State : NY
Zip : 10923-1552
Country : US
Telephone Number : 845-947-2240
Fax Number : 845-947-2265
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2005
Last Update Date : 04/27/2020

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