Provider Demographics
NPI:1881688851
Name:HARRIS, LEON S (MD)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:S
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20 GRAND STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-353-5600
Mailing Address - Fax:845-987-5979
Practice Address - Street 1:2 CROSFIELD AVE
Practice Address - Street 2:SUITE 318
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2226
Practice Address - Country:US
Practice Address - Phone:845-353-5600
Practice Address - Fax:845-353-5668
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2019-01-02
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Provider Licenses
StateLicense IDTaxonomies
NY135143207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
123213OtherAETNA/USHC
2900090OtherGHI
OX1379OtherHIP
0672649005OtherCIGNA HMO, POS
0D0735OtherHEALTHNET OF NORTHEAST
132995699OtherCIGNA PPO
132995699OtherFIDELIS (MEDICAID HMO)
132995699OtherINDECS(ORANGE-ULSTER SCHL
NY00913240Medicaid
132995699OtherHEALTH NOW
132995699OtherLOCAL 1199
132995699OtherMAGNACARE PPO
132995699OtherFAM HEALTH PLUS(HUDSON HP
4458461OtherAETNA
58A091OtherBC/BS EMPIRE
132995699OtherHUDSON HEALTH PLAN
132995699OtherBEECH STREET NETWORK
132995699OtherHORIZON HEALTHCARE OF NY
132995699OtherMAGNACARE PPO
0672649005OtherCIGNA HMO, POS