Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD044737E | PA |
Y | 207VE0102X | Reproductive Endocrinologist | MD044737E | PA |
NPI | 1235193863 |
---|---|
Provider Name | Richard S Legro |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033-2086 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 25/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014142900004 | (05) | PA |
F54368 | (02) |