Provider Demographics
NPI:1215195896
Name:LEIBOVITZ, ALON ARI (MD)
Entity Type:Individual
Prefix:MR
First Name:ALON
Middle Name:ARI
Last Name:LEIBOVITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10 UNION SQ E STE 2J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3314
Mailing Address - Country:US
Mailing Address - Phone:212-844-8300
Mailing Address - Fax:212-844-8338
Practice Address - Street 1:10 UNION SQ E STE 2J
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3314
Practice Address - Country:US
Practice Address - Phone:212-844-8300
Practice Address - Fax:212-844-8338
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY249500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics