Organization
MARTIN L. LEIB MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN L. LEIB M.D (DIRECT OWNER)
(212) 305-2303
Entity
Organization
Contact information
Practice address
635 W 165TH ST, SUITE 230, NEW YORK, NY 10032-3724
(212) 305-2303
Mailing address
635 W 165TH ST, SUITE 230, NEW YORK, NY 10032-3724
(212) 305-2303
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
124928
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00370356
—
NY
01
—
124928
LICENSE
NY
Enumeration date
06/30/2008
Last updated
03/05/2013
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