Provider Demographics
NPI:1134297062
Name:LEONE, ANTHONY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:LEONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 PARK CLUB LN
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5270
Mailing Address - Country:US
Mailing Address - Phone:716-667-7463
Mailing Address - Fax:716-276-8356
Practice Address - Street 1:192 PARK CLUB LN
Practice Address - Street 2:SUITE 120
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5242
Practice Address - Country:US
Practice Address - Phone:716-667-7463
Practice Address - Fax:716-276-8356
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199038207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0005401597OtherAETNA
NY00010340301OtherUNIVERA
NY199038-1OtherWORKERS COMPENSATION
NY6012034OtherGHI
NY0909726OtherINDEPENDENT HEALTH ASSOC.
NY01657212Medicaid
NY6012034OtherGHI
NY199038-1OtherWORKERS COMPENSATION