Individual ProviderMarshall LeonardEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address100 Nicolls Rd, Hsc, L4 Rm 50, Stony Brook, NY 11794-0001(631) 444-2478PECOS EnrollmentBased on the most recent information from CMS, provider Marshall Leonard is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1902255318Provider TypeIndividualFull NameLeonard, MarshallCredentialMDGenderMaleSole ProprietorNoEnumeration Date6/7/2016Last Updated7/29/2020Contact InformationPractice LocationPractice Address100 Nicolls Rd, Hsc, L4 Rm 50, Stony Brook, NY 11794-0001Phone(631) 444-2478FaxUnlisted FaxMailing LocationMailing AddressDepartment Of Emergency Medicine, 100 Nicolls Rd. Hsc, L-4, Rm 050, Stony Brook, NY 11794Phone(631) 444-2478FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicense298264New YorkCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer