Mark Van Leuven, PT
Individual provider Active NPI Specialist · Troy, NY
NPI 1114994266 · NPPES record last updated Feb 14, 2008
Key facts
- NPI
- 1114994266
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 015588-1 (NY)
- Practice address
- 564 Hoosick St
Troy, NY 12180-2106 - Phone
- (518) 273-2715
- Fax
- (518) 273-2815
- NPI assigned
- Mar 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015588-1 | NY | MD | Specialist |
| 15588 | NY | MD | Music Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Associates of Schenectady, P.C. | Past | Accepting new patients | |
| Physical Therapy Associates of Schenectady, P.C. | Past | Accepting new patients | |
| Physical Therapy Associates of Schenectady, P.C. | Past | Accepting new patients | |
| Physical Therapy Associates of Schenectady, PC | Past | Accepting new patients | |
| Athletic Dynamics LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 015588-1 | NY | Yes |
Addresses
Primary practice location
564 Hoosick St
Troy, NY 12180-2106
Mailing address
564 Hoosick St
Troy, NY 12180-2106
Phone (518) 273-2715
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02251054 | Medicaid | NY |
Other providers in Troy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.