Provider Demographics
NPI:1891738076
Name:ROBERT G. LEONE, MD PC
Entity Type:Organization
Organization Name:ROBERT G. LEONE, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-398-3617
Mailing Address - Street 1:434 ROUTE 134
Mailing Address - Street 2:SUITE C-2
Mailing Address - City:SOUTH DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02660-3433
Mailing Address - Country:US
Mailing Address - Phone:509-398-3617
Mailing Address - Fax:
Practice Address - Street 1:434 ROUTE 134
Practice Address - Street 2:SUITE C-2
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-3433
Practice Address - Country:US
Practice Address - Phone:509-398-3617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPENDINGMedicaid
MAPENDINGMedicaid