Provider Demographics
NPI:1619173242
Name:BODAPATI, LEENA (MD)
Entity Type:Individual
Prefix:DR
First Name:LEENA
Middle Name:
Last Name:BODAPATI
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 1:451 CLARKSON AVE, E BLDG, 7TH FL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203
Mailing Address - Country:US
Mailing Address - Phone:718-245-3325
Mailing Address - Fax:718-245-5587
Practice Address - Street 1:451 CLARKSON AVE, E BLDG, 7TH FL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-245-3325
Practice Address - Fax:718-245-5587
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266288207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine