Provider Demographics
NPI:1235428558
Name:LEONARD J DEUTSCH MD PA
Entity Type:Organization
Organization Name:LEONARD J DEUTSCH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:UNGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-860-3393
Mailing Address - Street 1:9801 COLLINS AVE APT 14Z
Mailing Address - Street 2:
Mailing Address - City:BAL HARBOUR
Mailing Address - State:FL
Mailing Address - Zip Code:33154-1830
Mailing Address - Country:US
Mailing Address - Phone:305-865-1141
Mailing Address - Fax:305-861-7167
Practice Address - Street 1:9801 COLLINS AVE APT 14Z
Practice Address - Street 2:
Practice Address - City:BAL HARBOUR
Practice Address - State:FL
Practice Address - Zip Code:33154-1830
Practice Address - Country:US
Practice Address - Phone:305-865-1141
Practice Address - Fax:305-861-7167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00116402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD46914Medicare UPIN