Provider Demographics
NPI:1538187273
Name:HONIKMAN, LESLIE ALLAN (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ALLAN
Last Name:HONIKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2281 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5102
Mailing Address - Country:US
Mailing Address - Phone:718-375-2777
Mailing Address - Fax:718-375-2779
Practice Address - Street 1:2281 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5102
Practice Address - Country:US
Practice Address - Phone:718-375-2777
Practice Address - Fax:718-375-2779
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101879207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY840821OtherBC/BS
NY0059573OtherGHI
NY00492140Medicaid
NY0059573OtherGHI
NY840821Medicare ID - Type Unspecified