Individual provider Active NPI

Leonardo M. Leiderman, PSY.D.,ABPP

  • Clinical Psychologist
  • Harrison, NY
National Provider Identifier
1720121197
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
013117 Issued in NY
Practice address
275 North St
Harrison, NY 10528-1524
Phone
(914) 925-5357
Fax
(914) 925-5169
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 013117 NY Primary

Addresses

Primary practice location

275 North St
Harrison, NY 10528-1524

Mailing address

8 Lower Salem Rd
South Salem, NY 10590-1215
Phone (914) 925-5357

Other names 1

  • Dr. Leo M. Leiderman Other name

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
013117NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720121197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LOWER SALEM RD",
            "city": "SOUTH SALEM",
            "state": "NY",
            "postal_code": "105901215",
            "telephone_number": "914-925-5357",
            "fax_number": "914-925-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 NORTH ST",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105281524",
            "telephone_number": "914-925-5357",
            "fax_number": "914-925-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIDERMAN",
        "first_name": "LEONARDO",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.,ABPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEO",
            "last_name": "LEIDERMAN",
            "middle_name": "M.",
            "prefix": "DR.",
            "credential": "PSY.D.,ABPP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harrison, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.