Provider Demographics
NPI:1215004858
Name:SHEIN, LEON ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:ROBERT
Last Name:SHEIN
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 1:15 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3036
Mailing Address - Country:US
Mailing Address - Phone:718-613-4442
Mailing Address - Fax:718-613-4885
Practice Address - Street 1:1545 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-1122
Practice Address - Country:US
Practice Address - Phone:718-613-4442
Practice Address - Fax:718-613-4885
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168451207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01164070Medicaid
E62449Medicare UPIN
NY63F601Medicare ID - Type Unspecified