MEDICARE: DR. LEONID REYFMAN 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	207LP2900X	Pain Medicine (Anesthesiology) Physician	233144	NY
2	208VP0014X	Interventional Pain Medicine Physician	233144	NY

General Provider Information

NPI Number	:	1659440394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONID REYFMAN MD

Provider Business Mailing Address
First Line	:	2279 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3337
Country	:	US
Telephone Number	:	718-998-9890
Fax Number	:	718-998-9891

Provider Business Practice Location Address
First Line	:	2277-83 CONEY ISLAND AVE
Second Line	:	SUITE 2A
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3337
Country	:	US
Telephone Number	:	718-998-9890
Fax Number	:	718-998-9891

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	09/24/2018

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