Provider Demographics
NPI:1386604957
Name:FINK, LEO P (DO)
Entity type:Individual
Prefix:
First Name:LEO
Middle Name:P
Last Name:FINK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:152 ISLIP AVE
Mailing Address - Street 2:STE 22
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3225
Mailing Address - Country:US
Mailing Address - Phone:631-277-1616
Mailing Address - Fax:631-277-1804
Practice Address - Street 1:152 ISLIP AVE
Practice Address - Street 2:STE 22
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3225
Practice Address - Country:US
Practice Address - Phone:631-277-1616
Practice Address - Fax:631-277-1804
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2011-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY198967207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG39650Medicare UPIN
NY922781Medicare ID - Type Unspecified