Provider Demographics
NPI:1649215690
Name:VILENSKY, LEONID (MD)
Entity Type:Individual
Prefix:
First Name:LEONID
Middle Name:
Last Name:VILENSKY
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 1:141 SULLYS TRL
Mailing Address - Street 2:STE 3
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4563
Mailing Address - Country:US
Mailing Address - Phone:585-747-4226
Mailing Address - Fax:855-783-4296
Practice Address - Street 1:135 SULLY TRAIL
Practice Address - Street 2:SUITE:5
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534
Practice Address - Country:US
Practice Address - Phone:585-747-4226
Practice Address - Fax:855-783-4296
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220382-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02142616Medicaid
NY02142616Medicaid
H37251Medicare UPIN