Leon, Luis Diego

Leon, Luis Diego is an individual health care provider with primary practice located at 1115 West St , Southington CT 06489-6025. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Leon, Luis Diego can be contacted via phone (860) 679-2766.

Contact Information

Primary practice address
1115 West St Southington CT 06489-6025
Phone: (860) 679-2766
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 049613 Connecticut
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 049613 Connecticut

Profile Details

NPI number 1235361759
LBN Legal business name Leon, Luis Diego
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2009
Last updated Sep 12th, 2022 - about 3 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 1235361759 NPPES
Connecticut MEDICAID 008036398

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