Provider Demographics
NPI:1396705729
Name:PHILIP, LEENA (MC)
Entity type:Individual
Prefix:DR
First Name:LEENA
Middle Name:
Last Name:PHILIP
Suffix:
Gender:F
Credentials:MC
Other - Prefix:DR
Other - First Name:LEENA
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1872 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4430
Mailing Address - Country:US
Mailing Address - Phone:914-962-3303
Mailing Address - Fax:914-962-4271
Practice Address - Street 1:1872 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4430
Practice Address - Country:US
Practice Address - Phone:914-962-3303
Practice Address - Fax:914-962-4271
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225325207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH90710Medicare UPIN
NY77S971Medicare ID - Type Unspecified