Provider Demographics
NPI:1922707678
Name:LEID, CRAIG KAREEM
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:KAREEM
Last Name:LEID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5823
Mailing Address - Country:US
Mailing Address - Phone:484-597-9409
Mailing Address - Fax:
Practice Address - Street 1:4807 FOSTER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-5823
Practice Address - Country:US
Practice Address - Phone:484-597-9409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company