MEDICARE: ELLA LEERS 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	207QA0401X	Addiction Medicine (Family Medicine) Physician	220125	NY
2	207Q00000X	Family Medicine Physician	220125	NY

General Provider Information

NPI Number	:	1609958305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLA LEERS MD

Provider Business Mailing Address
First Line	:	550 WASHINGTON ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-3627
Country	:	US
Telephone Number	:	888-926-9385
Fax Number	:	212-273-4496

Provider Business Practice Location Address
First Line	:	550 WASHINGTON ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-3627
Country	:	US
Telephone Number	:	888-926-9385
Fax Number	:	212-273-4496

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	05/29/2024

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Directions to “ ELLA LEERS MD” Practice Location

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