Provider Demographics
NPI:1669715702
Name:LEAF MEDICAL, PLLC
Entity type:Organization
Organization Name:LEAF MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNWOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-529-5323
Mailing Address - Street 1:18 ADAMS STREET
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1172
Mailing Address - Country:US
Mailing Address - Phone:855-529-5323
Mailing Address - Fax:855-765-5323
Practice Address - Street 1:18 ADAMS STREET
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1172
Practice Address - Country:US
Practice Address - Phone:855-529-5323
Practice Address - Fax:855-765-5323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265554261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care