NPIMap

Organization Active NPI

Marie Laura Leon M.D P.C

  • Pediatric Adolescent Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1750456406
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
196577 Issued in NY
Legal business name
MARIE LAURA LEON M.D P.C
Practice address
391 Eastern Pkwy
Brooklyn, NY 11216-4153
Phone
(718) 613-1600
Fax
(718) 613-1666
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Authorized official

Name
Marlena Simpson, CPMSM
Title
Director
Phone
(646) 680-2894

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X 196577 NY Primary

Addresses

Primary practice location

391 Eastern Pkwy
Brooklyn, NY 11216-4153

Mailing address

441 9TH Ave
Acp Credentialing Office - 3Rd Floor
New York, NY 10001-1623
Phone (646) 680-2894

Other identifiers 1

IdentifierTypeStateIssuer
01682782MedicaidNY

National Provider Directory

National Provider Directory

Locations

441 9th Ave
Ofc 3RD
New York, NY 10001

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1750456406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 9TH AVE",
            "address_2": "ACP CREDENTIALING OFFICE - 3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100011623",
            "telephone_number": "646-680-2894",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 EASTERN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112164153",
            "telephone_number": "718-613-1600",
            "fax_number": "718-613-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIE LAURA LEON M.D P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "MARLENA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "646-680-2894",
        "authorized_official_credential": "CPMSM"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "196577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01682782",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.