Legacy Medical PLLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

199052-1 Issued in NY

Legal business name

LEGACY MEDICAL PLLC

Practice address

19 W 34TH St
Suite1200
New York, NY 10001-3006

Phone

(212) 924-7676

Fax

(212) 924-7676

NPI assigned

Aug 7, 2012

Organization subpart

No

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

Authorized official

Name

Madhu Boppana, M.D.

Title

Owner

Phone

(212) 924-7676

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344297600000",
    "number": "1659628832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WEST 34TH STREET",
            "address_2": "SUITE1200",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013006",
            "telephone_number": "212-924-7676",
            "fax_number": "212-531-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 W 34TH ST",
            "address_2": "SUITE1200",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013006",
            "telephone_number": "212-924-7676",
            "fax_number": "212-924-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-07",
        "last_updated": "2012-08-07",
        "status": "A",
        "authorized_official_last_name": "BOPPANA",
        "authorized_official_first_name": "MADHU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-924-7676",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "199052-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sondra Leftoff, PHD
• Daniel Russell Lefton, MD
• Joy Leftow, LCSW
• Leg Foot & Ankle Associates PC
• Legacy House Inc
• Jaclyn Legacy
• Legacyivf
• Priscilla Daphne Legagneur, CRNA
• Ebone Latoya Legall, PA-C
• Lori Anne Legano, M.D.

• Neurology Physician in New York, NY
• Providers in New York, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; 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.