Provider Demographics
NPI:1659340461
Name:LEONE, JAMES MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:LEONE
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 1:354 BIRNIE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1108
Mailing Address - Country:US
Mailing Address - Phone:413-733-3470
Mailing Address - Fax:413-733-5235
Practice Address - Street 1:2377 BOSTON RD
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095
Practice Address - Country:US
Practice Address - Phone:413-596-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74824207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3087573Medicaid
MAJ13022Medicare PIN
MA3087573Medicaid
110201796Medicare PIN