Provider Demographics
NPI:1083053979
Name:JOEL, LEORA (MD)
Entity Type:Individual
Prefix:DR
First Name:LEORA
Middle Name:
Last Name:JOEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 MAPLE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4710
Mailing Address - Country:US
Mailing Address - Phone:914-328-8444
Mailing Address - Fax:914-428-7696
Practice Address - Street 1:170 MAPLE AVE FL 4
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4710
Practice Address - Country:US
Practice Address - Phone:914-328-8444
Practice Address - Fax:914-428-7696
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY289383-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program