Individual
DR. LEONARD TRAVAGLIONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
300 WASHINGTON AVENUE EXT, ALBANY, NY 12203-7303
(518) 392-7314
(518) 862-2175
Mailing address
300 WASHINGTON AVENUE EXT, ALBANY, NY 12203-7303
(518) 392-7314
(518) 862-2175
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
011531
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011531
LICENSE
NY
05
—
01416760
—
NY
05
—
01905259
—
NY
01
—
134284
VALUE OPTIONS
NY
Enumeration date
09/23/2006
Last updated
06/14/2017
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