Provider Demographics
NPI:1174563761
Name:GROSSMAN, LEONARD J (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:J
Last Name:GROSSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:LB# 7550 PO BOX 95000
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-7550
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:1911 US HIGHWAY 46
Practice Address - Street 2:
Practice Address - City:LEDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07852
Practice Address - Country:US
Practice Address - Phone:973-347-8500
Practice Address - Fax:973-347-7320
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2017-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02924700208000000X, 2080A0000X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Not Answered2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology