Provider Demographics
NPI:1386627701
Name:LEOPOLD, HARRIS B (MD)
Entity Type:Individual
Prefix:
First Name:HARRIS
Middle Name:B
Last Name:LEOPOLD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:282 WASHINGTON ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-3322
Mailing Address - Country:US
Mailing Address - Phone:860-545-9216
Mailing Address - Fax:860-545-9414
Practice Address - Street 1:282 WASHINGTON ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3322
Practice Address - Country:US
Practice Address - Phone:860-545-9216
Practice Address - Fax:860-545-9414
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0288522080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001288522Medicaid
CT001288522Medicaid
CTE52542Medicare UPIN