Individual
LEONARD ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 HARRISON ST, SUITE 455, JOHNSON CITY, NY 13790-2161
(607) 763-8100
(607) 763-8048
Mailing address
346 GRAND AVE, JOHNSON CITY, NY 13790-2580
(607) 729-8156
(607) 729-2209
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
192394
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01415796
—
NY
Enumeration date
07/29/2005
Last updated
11/18/2011
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