Provider Demographics
NPI:1376652040
Name:LEBLANG, DENIS (DPM)
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:
Last Name:LEBLANG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:DENIS
Other - Middle Name:
Other - Last Name:LEBLANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:285 N ROUTE 303 STE 15
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-1425
Mailing Address - Country:US
Mailing Address - Phone:845-268-8282
Mailing Address - Fax:845-268-8298
Practice Address - Street 1:285 N ROUTE 303 STE 15
Practice Address - Street 2:
Practice Address - City:CONGERS
Practice Address - State:NY
Practice Address - Zip Code:10920-1425
Practice Address - Country:US
Practice Address - Phone:845-268-8282
Practice Address - Fax:845-268-8298
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002957213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN002957OtherCIGNA
NY00497338Medicaid
T50922Medicare UPIN