MEDICARE: LEON S HARRIS 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	207RP1001X	Pulmonary Disease Physician	135143	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	123213	OTHER	AETNA/USHC
2	2900090	OTHER	GHI
3	OX1379	OTHER	HIP
4	0672649005	OTHER	CIGNA HMO, POS
5	0D0735	OTHER	HEALTHNET OF NORTHEAST
6	132995699	OTHER	CIGNA PPO
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	132995699	OTHER	INDECS(ORANGE-ULSTER SCHL
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	132995699	OTHER	HEALTH NOW
11	132995699	OTHER	LOCAL 1199
12	132995699	OTHER	MAGNACARE PPO
13	132995699	OTHER	FAM HEALTH PLUS(HUDSON HP
14	4458461	OTHER	AETNA
15	58A091	OTHER	BC/BS EMPIRE
16	132995699	OTHER	HUDSON HEALTH PLAN
17	132995699	OTHER	BEECH STREET NETWORK
18	132995699	OTHER	HORIZON HEALTHCARE OF NY

General Provider Information

NPI Number	:	1881688851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEON S HARRIS MD

Provider Business Mailing Address
First Line	:	20 GRAND STREET
Second Line	:	3RD FLOOR
City	:	WARWICK
State	:	NY
Zip	:	10990-1035
Country	:	US
Telephone Number	:	845-353-5600
Fax Number	:	845-987-5979

Provider Business Practice Location Address
First Line	:	2 CROSFIELD AVE
Second Line	:	SUITE 318
City	:	WEST NYACK
State	:	NY
Zip	:	10994-2226
Country	:	US
Telephone Number	:	845-353-5600
Fax Number	:	845-353-5668

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	01/02/2019

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Directions to “ LEON S HARRIS MD” Practice Location

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