Provider Demographics
NPI:1336374552
Name:LEONARD, MAUREEN MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:MICHELLE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SKYLINE RD
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02136-3946
Mailing Address - Country:US
Mailing Address - Phone:617-834-9329
Mailing Address - Fax:
Practice Address - Street 1:755 WASHINGTON ST.
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics