Individual
JOHN LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 BROAD STREET PLZ, GLENS FALLS, NY 12801-4363
(518) 793-0519
Mailing address
2 NICKLAUS DR, GANSEVOORT, NY 12831-1762
(518) 584-5224
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
112058
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
112058
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01020319
—
NY
Enumeration date
07/06/2006
Last updated
01/31/2008
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