Provider Demographics
NPI:1023181476
Name:MAYER, LEONARD R (DC)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:R
Last Name:MAYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 WILLOW LAWN DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3427
Mailing Address - Country:US
Mailing Address - Phone:804-285-4400
Mailing Address - Fax:804-285-4500
Practice Address - Street 1:1601 WILLOW LAWN DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3427
Practice Address - Country:US
Practice Address - Phone:804-285-4400
Practice Address - Fax:804-285-4500
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYX3362111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX4O49OtherEMPIRE BCBS
NY5898209OtherGHI
NY79652OtherUNITED HEALTHCARE
NY4566057OtherAETNA
NYP413806OtherOXFORD
NY79652OtherUNITED HEALTHCARE