Provider Demographics
NPI:1427139229
Name:RENEE LEFLAND ,MD,PC
Entity type:Organization
Organization Name:RENEE LEFLAND ,MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:EYMOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-222-0935
Mailing Address - Street 1:877 STEWART AVE
Mailing Address - Street 2:SUITE 25
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4803
Mailing Address - Country:US
Mailing Address - Phone:516-222-0404
Mailing Address - Fax:516-222-0615
Practice Address - Street 1:877 STEWART AVE
Practice Address - Street 2:SUITE 25
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4803
Practice Address - Country:US
Practice Address - Phone:516-222-0404
Practice Address - Fax:516-222-0615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW4L581Medicare ID - Type Unspecified