Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | MD459858 | PA |
NPI | 1184863953 |
---|---|
Provider Name | Dr. Jacques Robert Leclerc |
First Address | Lemoyne, PA 17043-1218 |
Second Address | Lemoyne, PA 17043-1218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2009 |
Last Update Date | 11/02/2019 |