Provider Demographics
NPI:1285876961
Name:RIEPER, LEIGH ALEXANDRA (DO)
Entity type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:ALEXANDRA
Last Name:RIEPER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 MAIN STREET
Mailing Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2913
Mailing Address - Country:US
Mailing Address - Phone:845-831-0400
Mailing Address - Fax:845-831-0793
Practice Address - Street 1:6 HENRY ST
Practice Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-3058
Practice Address - Country:US
Practice Address - Phone:845-831-0040
Practice Address - Fax:845-831-0793
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252418207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03165060Medicaid
NYA400059195Medicare PIN