Provider Demographics
NPI:1487667739
Name:LEONE, VINCENT J (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:J
Last Name:LEONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 222076
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11022-2076
Mailing Address - Country:US
Mailing Address - Phone:576-622-7980
Mailing Address - Fax:516-498-9385
Practice Address - Street 1:833 NORTHERN BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5308
Practice Address - Country:US
Practice Address - Phone:516-622-7980
Practice Address - Fax:516-498-9385
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY171524207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
89F04Medicare ID - Type Unspecified
E94735Medicare UPIN