Provider Demographics
NPI:1801894241
Name:LEONE, ENZO J (DPM)
Entity type:Individual
Prefix:DR
First Name:ENZO
Middle Name:J
Last Name:LEONE
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Gender:M
Credentials:DPM
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Mailing Address - Street 1:1600 E GUDE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1341
Mailing Address - Country:US
Mailing Address - Phone:301-933-7133
Mailing Address - Fax:301-933-7137
Practice Address - Street 1:8028 GOV RITCHIE HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1075
Practice Address - Country:US
Practice Address - Phone:410-768-5800
Practice Address - Fax:410-768-5806
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2018-11-28
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Provider Licenses
StateLicense IDTaxonomies
MD01390213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403061300Medicaid
MD4678050001Medicare NSC
MD226513YFCHMedicare PIN
MD403061300Medicaid