Provider Demographics
NPI:1821076746
Name:LEOPOLD, HOWARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:LEOPOLD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PLAZA ST E
Mailing Address - Street 2:9C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4954
Mailing Address - Country:US
Mailing Address - Phone:718-857-4650
Mailing Address - Fax:718-857-4650
Practice Address - Street 1:1 PLAZA ST W
Practice Address - Street 2:1D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3748
Practice Address - Country:US
Practice Address - Phone:718-857-4650
Practice Address - Fax:718-857-4650
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008968-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV07251Medicare ID - Type Unspecified