Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 244795 | NY |
NPI | 1295969046 |
---|---|
Provider Name | Dr. Andrew Joseph Leo |
First Address | Hauppauge, NY 11788 |
Second Address | Hauppauge, NY 11788 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2009 |
Last Update Date | 12/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03853289 | (05) | NY |