| VR Leddy, M.D., P.C. | |
|
160 Fourth Street Brentwood NY 11717 | |
| (631) 273-7105 | |
| (631) 273-7253 |
| Full Name | VR Leddy, M.D., P.C. |
|---|---|
| Speciality | Internal Medicine |
| Location | 160 Fourth Street, Brentwood, New York |
| Authorized Official Name and Position | Vincent Richard Leddy (PRESIDENT) |
| Authorized Official Contact | 6312737105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| VR Leddy, M.D., P.C. 160 Fourth Street Brentwood NY 11717 Ph: (631) 273-7105 | VR Leddy, M.D., P.C. 160 Fourth Street Brentwood NY 11717 Ph: (631) 273-7105 |
| NPI Number | 1275768327 |
|---|---|
| Provider Enumeration Date | 05/19/2009 |
| Last Update Date | 09/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275768327 | NPI | - | NPPES |
| 1538201231 | Other | NY | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 152061 (New York) | Primary |
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