Provider Demographics
NPI:1225195258
Name:EPISCOPIO, LEONARD G (DDS)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:G
Last Name:EPISCOPIO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1522
Mailing Address - Country:US
Mailing Address - Phone:845-986-2929
Mailing Address - Fax:
Practice Address - Street 1:31 OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1522
Practice Address - Country:US
Practice Address - Phone:845-986-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0450841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice