Individual
LEIF ODD HOLGERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
141 S CENTRAL AVE, HARTSDALE, NY 10530-2319
(914) 337-2455
(914) 380-6713
Mailing address
PO BOX 667, PURCHASE, NY 10577-0667
(914) 337-2455
(914) 380-6713
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
097983
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00166087
—
NY
Enumeration date
05/31/2006
Last updated
07/08/2007
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