Provider Demographics
NPI:1215020474
Name:SCRIMMAGER, LEON (MD)
Entity type:Individual
Prefix:DR
First Name:LEON
Middle Name:
Last Name:SCRIMMAGER
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 1:470 LENOX AVE
Mailing Address - Street 2:APT 1P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-3012
Mailing Address - Country:US
Mailing Address - Phone:646-295-4422
Mailing Address - Fax:212-249-1640
Practice Address - Street 1:470 LENOX AVE
Practice Address - Street 2:APT 1P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-3012
Practice Address - Country:US
Practice Address - Phone:212-249-1627
Practice Address - Fax:212-249-1640
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184535207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine