MEDICARE: DR. LEONARD HARVEY MANN DMD

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
1	1223G0001X	General Practice Dentistry	033252	NY

General Provider Information

NPI Number	:	1144227141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD HARVEY MANN DMD

Provider Business Mailing Address
First Line	:	216B KEARSING PKWY
Second Line	:
City	:	MONSEY
State	:	NY
Zip	:	10952-2206
Country	:	US
Telephone Number	:	845-426-3810
Fax Number	:

Provider Business Practice Location Address
First Line	:	93 RTE. 303
Second Line	:
City	:	TAPPAN
State	:	NY
Zip	:	10983-2514
Country	:	US
Telephone Number	:	845-359-1770
Fax Number	:	845-359-2798

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/08/2007

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