Provider Demographics
NPI:1396798872
Name:KOZER, LEONID (MD)
Entity type:Individual
Prefix:
First Name:LEONID
Middle Name:
Last Name:KOZER
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 1:1550 E 13TH ST
Mailing Address - Street 2:APT 6-G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7158
Mailing Address - Country:US
Mailing Address - Phone:718-375-2825
Mailing Address - Fax:718-375-4231
Practice Address - Street 1:1729 E 12TH ST FL 2NF
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1088
Practice Address - Country:US
Practice Address - Phone:718-375-2825
Practice Address - Fax:718-375-4231
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210014207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01952501Medicaid
NY417P42Medicare PIN
NY01952501Medicaid