Individual provider Active NPI

Leila Bender Laitman, M.D.

  • Psychiatry Physician
  • Great Neck, NY
National Provider Identifier
1962406819
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
155185 Issued in NY
Practice address
17 Barstow Rd
Ste 400
Great Neck, NY 11021-2213
Phone
(516) 487-5700
NPI assigned
Jun 9, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 155185 NY Primary
Geriatric Psychiatry Physician 2084P0805X 155185 NY

Addresses

Primary practice location

17 Barstow Rd
Ste 400
Great Neck, NY 11021-2213

Mailing address

30 Parkside Dr
Great Neck, NY 11021-1023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110222000802 NY Practitioner - Geriatric PsychiatryPractitioner - Psychiatry 3870786189 Practice locations: Great Neck, NY

Care Compare profile

Medicare Care Compare
Specialty
Geriatric PsychiatryAlso: Psychiatry
Education
Icahn School of Medicine at Mount Sinai, 1981
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

17 Barstow Rd
Great Neck, NY 11021-2213
Phone (516) 487-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1962406819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PARKSIDE DR",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BARSTOW RD",
            "address_2": "STE 400",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212213",
            "telephone_number": "516-487-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAITMAN",
        "first_name": "LEILA",
        "middle_name": "BENDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "155185",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NY",
            "license": "155185",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.