Individual
DR. BRUCE J LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 IRVING AVE, SUITE 100, SYRACUSE, NY 13210
(315) 464-5533
(802) 847-8158
Mailing address
251 SALINA MEADOWS PKWY, SUITE 100, SYRACUSE, NY 13212-4516
(315) 464-2000
(315) 464-2010
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
042-0007764
VT
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
168144
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01087365
—
NY
Enumeration date
07/22/2006
Last updated
06/16/2021
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