Provider Demographics
NPI:1346248960
Name:FREEMAN, LEONARD (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:FREEMAN
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 1:50 SUTTON PL S
Mailing Address - Street 2:APT.11A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4167
Mailing Address - Country:US
Mailing Address - Phone:212-688-9395
Mailing Address - Fax:212-688-9351
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-6060
Practice Address - Fax:718-920-2629
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087763-1207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00138087Medicaid
NY00138087Medicaid
CO6442Medicare UPIN