Gloria Dunnder Leacock, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

204175 Issued in NY

Practice address

3096 51St St
Woodside, NY 11377-1457

Phone

(718) 204-1469

Fax

(718) 545-1726

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: gdunnderleacock84030@nychhc.direct-ci.com

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1619040607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E 20TH ST",
            "address_2": "APT 9B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100098213",
            "telephone_number": "212-545-2400",
            "fax_number": "646-312-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3096 51ST ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771457",
            "telephone_number": "718-204-1469",
            "fax_number": "718-545-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNNDER LEACOCK",
        "first_name": "GLORIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "204175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Duane Reade
• Duane Reade
• Duane Reade
• Margaret Han Dugan, M.D.
• Dunn-Lea Medical PC
• Lan Ngoc Duong
• Meral Duran, DNP, RN, FNP-BC
• Helen Stephanie Dwork, LMSW
• Dynamic Physical Therapy of Queens PLLC
• E Zappi Dermatopathology Lab Inc.

• Family Medicine Physician in Woodside, NY
• Providers in Woodside, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; 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.