Provider Demographics
NPI:1811986904
Name:MAFFUCCI, LEONARD (MD FACS)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:MAFFUCCI
Suffix:
Gender:M
Credentials:MD FACS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2700 WESTCHESTER AVE
Mailing Address - Street 2:2ND
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2547
Mailing Address - Country:US
Mailing Address - Phone:914-681-3146
Mailing Address - Fax:914-457-1198
Practice Address - Street 1:210 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2901
Practice Address - Country:US
Practice Address - Phone:914-682-6557
Practice Address - Fax:914-681-5245
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY168873208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0214837Medicaid
NY0808HOtherEMPIRE BCBS
WS861OtherOXFORD
0D2741OtherHEALTHNET
NY0808HOtherEMPIRE BCBS
WS861OtherOXFORD