Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | OS-008832-L | PA |
NPI | 1043205214 |
---|---|
Provider Name | Dr. Leonard J. Leone |
First Address | Erie, PA 16502-4607 |
Second Address | Erie, PA 16502-4607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 30/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001547528 | (05) | PA |
11125127 | CAQH (01) | |
G17950 | (02) | PA |