Provider Demographics
NPI:1801862941
Name:LEVIN, LEONARD A (MD PHD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:A
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2396 GRAHAM BLVD
Mailing Address - Street 2:
Mailing Address - City:MONT-ROYAL
Mailing Address - State:QC
Mailing Address - Zip Code:H3R1H9
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5252 BOUL DE MAISONNEUVE OUEST
Practice Address - Street 2:STE 400
Practice Address - City:MONTREAL
Practice Address - State:QC
Practice Address - Zip Code:H4A3S5
Practice Address - Country:CA
Practice Address - Phone:514-843-1544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI34469-20207WX0109X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology