Provider Demographics
NPI:1659349553
Name:MULLER, LEONARD (MD,)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:MULLER
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:DR
Other - First Name:LEONID
Other - Middle Name:
Other - Last Name:MULLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8801 FORT HAMILTON PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6003
Mailing Address - Country:US
Mailing Address - Phone:718-680-2959
Mailing Address - Fax:718-748-4419
Practice Address - Street 1:8801 FT HAMILTON PARKWAY
Practice Address - Street 2:
Practice Address - City:BROOLKYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:718-680-2959
Practice Address - Fax:718-748-4419
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152108207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00766578Medicaid
NY12115Medicare ID - Type UnspecifiedQUEENS
NY00766578Medicaid