Provider Demographics
NPI:1164887832
Name:LEONARD, JAMES JORDAN
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:JORDAN
Last Name:LEONARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 E 21ST ST
Mailing Address - Street 2:APT 4I
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-7260
Mailing Address - Country:US
Mailing Address - Phone:347-513-5713
Mailing Address - Fax:
Practice Address - Street 1:585 E 21ST ST
Practice Address - Street 2:APT 4I
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-7260
Practice Address - Country:US
Practice Address - Phone:347-513-5713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-23
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information