Provider Demographics
NPI:1073532339
Name:LEONE, VINCENT M (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:M
Last Name:LEONE
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 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-0001
Mailing Address - Country:US
Mailing Address - Phone:860-679-4477
Mailing Address - Fax:860-679-4474
Practice Address - Street 1:1115 WEST ST
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-6025
Practice Address - Country:US
Practice Address - Phone:860-276-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035801207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2286124OtherAETNA
CT00135801002OtherBLUE CARE FAMILY PLAN
CT035801OtherCONNECTICARE
CT010035801CT03OtherANTHEM BC/BS
CT061571622OtherUNITED HEALTHCARE
CT061571622OtherCIGNA
CTP490553OtherOXFORD
CT001358010Medicaid
CT110201458OtherRAILROAD MEDICARE
CTOV6502OtherHEALTHNET
CTP490553OtherOXFORD
CT2286124OtherAETNA