Provider Demographics
NPI:1326066994
Name:GELMAN, LEONARD MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:MARK
Last Name:GELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:20 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-1367
Practice Address - Country:US
Practice Address - Phone:518-885-6721
Practice Address - Fax:518-885-5412
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY166891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY08132OtherMVP
NY7024613OtherAETNA
NY10000746OtherCDPHP
NY691671OtherEMPIRE BC
NY00964874Medicaid
NY000401337001OtherBSNENY
NY200060OtherSENIOR WHOLE HEALTH
NY070302000096OtherFIDELIS
NY47333OtherGHI/HMO
NY200060OtherSENIOR WHOLE HEALTH
NY47333OtherGHI/HMO