Provider Demographics
NPI:1790175891
Name:PEREIRA, LEANNE (MD)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:PEREIRA
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:PO BOX 28082
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-8082
Mailing Address - Country:US
Mailing Address - Phone:212-987-3100
Mailing Address - Fax:212-987-1799
Practice Address - Street 1:300 CADMAN PLZ W FL 18
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:929-210-6000
Practice Address - Fax:929-210-6001
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288867207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400181040OtherMEDICARE
NY04875476Medicaid
NY288867OtherNYS MEDICAL LICENSE
NY288867OtherNYS MEDICAL LICENSE