Provider Demographics
NPI:1386759843
Name:YAMPOLSKY, LEONID (PHD)
Entity type:Individual
Prefix:DR
First Name:LEONID
Middle Name:
Last Name:YAMPOLSKY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 BAY PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-3969
Mailing Address - Country:US
Mailing Address - Phone:718-331-3800
Mailing Address - Fax:718-331-3387
Practice Address - Street 1:6415 BAY PARKWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204
Practice Address - Country:US
Practice Address - Phone:718-331-3800
Practice Address - Fax:718-331-3387
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013244103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical