Provider Demographics
NPI:1184680449
Name:STEIN, LEONARD A (MD & PHD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:A
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD & PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MARWOOD PL
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2923
Mailing Address - Country:US
Mailing Address - Phone:631-689-9631
Mailing Address - Fax:
Practice Address - Street 1:31 MARWOOD PL
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2923
Practice Address - Country:US
Practice Address - Phone:631-689-9631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY126697207R00000X, 207U00000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE87588Medicare UPIN
NYRA6668Medicare ID - Type UnspecifiedUPSTATE
NY00767799Medicare ID - Type Unspecified