# DR. BRUCE J LEAVITT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1720009871
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 042-0007764 | VT | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 168144 | NY | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 06/16/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01087365 | — | NY |