Provider Demographics
NPI:1821098245
Name:LEVEN, LEONARD I (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:I
Last Name:LEVEN
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 1:3 BAYBERRY RD
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-1701
Mailing Address - Country:US
Mailing Address - Phone:914-347-4510
Mailing Address - Fax:914-347-5020
Practice Address - Street 1:3 W END AVE
Practice Address - Street 2:
Practice Address - City:OLD GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06870-1640
Practice Address - Country:US
Practice Address - Phone:203-637-1486
Practice Address - Fax:203-637-1486
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0267442084P0800X, 2084P0804X
NY1673102084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTA64707Medicare UPIN