Provider Demographics
NPI:1548351018
Name:DIPAOLO, LEONARD J (OD)
Entity type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:J
Last Name:DIPAOLO
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:9 GREENHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-3303
Mailing Address - Country:US
Mailing Address - Phone:845-528-6595
Mailing Address - Fax:
Practice Address - Street 1:26 TRIANGLE CTR
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4104
Practice Address - Country:US
Practice Address - Phone:914-245-6138
Practice Address - Fax:914-245-6154
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYC003479156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0871140001Medicare NSC