Provider Demographics
NPI:1174521165
Name:LEVENTHAL, LAWRENCE J (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:LEVENTHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:727 WELSH RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6310
Mailing Address - Country:US
Mailing Address - Phone:215-947-8701
Mailing Address - Fax:215-947-9704
Practice Address - Street 1:727 WELSH RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6310
Practice Address - Country:US
Practice Address - Phone:215-947-8701
Practice Address - Fax:215-947-9704
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2021-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD034222E207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012000600005Medicaid
PAE55552Medicare UPIN