Provider Demographics
NPI:1609952308
Name:PARAGON EMERGENCY MEDICAL CARE, PC
Entity type:Organization
Organization Name:PARAGON EMERGENCY MEDICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:LENO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:914-964-4349
Mailing Address - Street 1:PO BOX 634863
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0042
Mailing Address - Country:US
Mailing Address - Phone:800-290-5282
Mailing Address - Fax:937-534-0166
Practice Address - Street 1:967 N BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1301
Practice Address - Country:US
Practice Address - Phone:914-964-4349
Practice Address - Fax:937-534-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWCW651Medicare ID - Type Unspecified