Provider Demographics
NPI:1417980590
Name:ZAMORE, LEONARD H (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:H
Last Name:ZAMORE
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 1:416 HIGHLAND AVE
Mailing Address - Street 2:BLDG B
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2531
Mailing Address - Country:US
Mailing Address - Phone:203-272-1688
Mailing Address - Fax:203-272-2447
Practice Address - Street 1:416 HIGHLAND AVE
Practice Address - Street 2:BLDG B
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2531
Practice Address - Country:US
Practice Address - Phone:203-272-1688
Practice Address - Fax:203-272-2447
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12382207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
010012382CT07OtherBCBS
0Q1962OtherHEALTHNET
CT001123827Medicaid
CT126805OtherCIGNA
CTNHP100OtherOXFORD
2220357OtherUS HEALTHCARE
012382OtherCONNECTICARE
CT160001765Medicare PIN
CT001123827Medicaid