Provider Demographics
NPI:1447380365
Name:LEIFER, DANA (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:
Last Name:LEIFER
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 1:525 E 68TH ST
Mailing Address - Street 2:ROOM F610
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-2454
Mailing Address - Fax:212-746-8026
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:ROOM F610
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4870
Practice Address - Country:US
Practice Address - Phone:212-746-2454
Practice Address - Fax:212-746-8026
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209087-12084N0400X, 2084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01809521Medicaid
595621Medicare ID - Type Unspecified
F45523Medicare UPIN