Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0202X | Pediatric Cardiologist | NC | |
Y | 2080P0202X | Pediatric Cardiologist | 240624-1 | NY |
N | 2080P0202X | Pediatric Cardiologist | ME80507 | FL |
NPI | 1194766659 |
---|---|
Provider Name | Dr. Glenn Taylor Leonard JR. |
First Address | East Amherst, NY 14051-2031 |
Second Address | Buffalo, NY 14209-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I17733 | (02) | NC |