Individual
GRIGORY LEONTYEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3304 PARK AVE, OCEANSIDE, NY 11572-4352
(516) 270-2126
(516) 255-2072
Mailing address
3304 PARK AVE, OCEANSIDE, NY 11572-4352
(516) 270-2126
(516) 255-2072
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
228112-1
NY
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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