MEDICARE: DR. LEONID VOROBYEV 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
1	2084P0800X	Psychiatry Physician	216549	NY
2	2084P0800X	Psychiatry Physician	MA71423	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1245259431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONID VOROBYEV MD

Provider Business Mailing Address
First Line	:	100 BELCHASE DR STE 101
Second Line	:
City	:	MATAWAN
State	:	NJ
Zip	:	07747-9728
Country	:	US
Telephone Number	:	732-707-4100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2502 86TH ST FL 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4440
Country	:	US
Telephone Number	:	718-236-0700
Fax Number	:

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	06/25/2024

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