Provider Demographics
NPI:1295727782
Name:LEONE, DONALD J (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:LEONE
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 1:82 KENSETT DR
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4420
Mailing Address - Country:US
Mailing Address - Phone:203-563-9484
Mailing Address - Fax:
Practice Address - Street 1:249 DANBURY ROAD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897
Practice Address - Country:US
Practice Address - Phone:203-762-3353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028837207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1295727782Medicaid
CTD02911Medicaid
CT110008050Medicare ID - Type Unspecified
CT1295727782Medicaid