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NPI Code Detail

MEDICARE: DR. JONATHAN LEIBOWITZ M.D.

MEDICARE: DR. JONATHAN LEIBOWITZ 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
1207RN0300XNephrology Physician198424NY
2207R00000XInternal Medicine Physician198424NY

General Provider Information

NPI Number : 1588665012
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN LEIBOWITZ M.D.
Provider Business Mailing Address
First Line : 1343 55TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-4202
Country : US
Telephone Number : 718-972-7222
Fax Number :
Provider Business Practice Location Address
First Line : 1343 55TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-4202
Country : US
Telephone Number : 718-972-7222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 11/27/2023

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