Leavitt, Bruce J

Leavitt, Bruce J is an individual health care provider with primary practice located at 725 Irving Ave Suite 100, Syracuse NY 13210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Leavitt, Bruce J can be contacted via phone (315) 464-5533.

Contact Information

Primary practice address
725 Irving Ave Suite 100 Syracuse NY 13210
Phone: (315) 464-5533
Fax: (802) 847-8158
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 168144 New York
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 042-0007764 Vermont

Profile Details

NPI number 1720009871
LBN Legal business name Leavitt, Bruce J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2006
Last updated Jun 16th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720009871 NPPES
New York MEDICAID 01087365

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