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NPI Code Detail

MEDICARE: DR. LEELAMMA JOSEPH M.D.,

MEDICARE:  DR. LEELAMMA  JOSEPH  M.D.,
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
1207R00000XInternal Medicine Physician240619NY

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 : 1154425171
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEELAMMA JOSEPH M.D.,
Provider Business Mailing Address
First Line : 600 EAST 125TH ST
Second Line : WARDS ISLAND
City : NEW YORK
State : NY
Zip : 10035
Country : US
Telephone Number : 646-672-6767
Fax Number :
Provider Business Practice Location Address
First Line : 102 RIVERS EDGE RD
Second Line :
City : NEW YORK
State : NY
Zip : 10035-1163
Country : US
Telephone Number : 646-672-6767
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2006
Last Update Date : 06/02/2023

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