Provider Demographics
NPI:1164466637
Name:LEONARDO, ROBERT FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:FRANCIS
Last Name:LEONARDO
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 1:10 EXCHANGE PL
Mailing Address - Street 2:14TH FL-WSBS
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3918
Mailing Address - Country:US
Mailing Address - Phone:201-830-3122
Mailing Address - Fax:201-200-0838
Practice Address - Street 1:424 E 89TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6703
Practice Address - Country:US
Practice Address - Phone:212-410-5100
Practice Address - Fax:212-410-2500
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2185152085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02092208Medicaid
H21898Medicare UPIN
NY977441Medicare PIN