Provider Demographics
NPI:1447238647
Name:LEONARD, AIMEE L (MD)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:L
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 MONTVALE AVE STE 3000
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3658
Mailing Address - Country:US
Mailing Address - Phone:781-358-8429
Mailing Address - Fax:
Practice Address - Street 1:92 MONTVALE AVE STE 3000
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3658
Practice Address - Country:US
Practice Address - Phone:781-358-8429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226620207ND0101X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ29895OtherBLUE CROSS BLUE SHIELD
226620OtherCONNECTICARE
MA37948OtherHEALTH NEW ENGLAND
MA226620OtherUNICARE GIC
2362236OtherCIGNA HEALTHCARE
MA226620OtherUNICARE GIC
I55819Medicare UPIN