Provider Demographics
NPI:1033287982
Name:LEV, LEONARD (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:LEV
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 1:19409 PLANTATION RD STE 4
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-4413
Mailing Address - Country:US
Mailing Address - Phone:914-714-8197
Mailing Address - Fax:
Practice Address - Street 1:19409 PLANTATION RD STE 4
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-4413
Practice Address - Country:US
Practice Address - Phone:914-714-8197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0372132084P0800X
DEC100241102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEFL0319257OtherDEA NUMBER