Individual provider Active NPI

Mark Eric Leder, D.C.

  • Chiropractor
  • New York, NY
National Provider Identifier
1467779918
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6079 Issued in NY
Practice address
928 Broadway Ste 304
New York, NY 10010-8154
Phone
(212) 686-2244
NPI assigned
Apr 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6079 NY Primary

Addresses

Primary practice location

928 Broadway Ste 304
New York, NY 10010-8154

Mailing address

1180 E Broadway Apt 1
Hewlett, NY 11557-2435
Phone (516) 295-1839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6079NYMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1467779918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 E BROADWAY APT 1",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115572435",
            "telephone_number": "516-295-1839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 BROADWAY STE 304",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100108154",
            "telephone_number": "212-686-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDER",
        "first_name": "MARK",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "6079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.