Provider Demographics
NPI:1003871088
Name:LEITMAN, BARRY STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:STEVEN
Last Name:LEITMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 1ST AVE
Mailing Address - Street 2:NBV 3W40
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-5526
Mailing Address - Fax:212-263-7666
Practice Address - Street 1:550 1ST AVE
Practice Address - Street 2:NBV 3W40
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-5526
Practice Address - Fax:212-263-7666
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1274232085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00599151Medicaid
NY32A71Medicare ID - Type Unspecified
NYB12926Medicare UPIN