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Individual

DR. LEONARD MENAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1628 JOHN F KENNEDY BLVD, SUITE # 2100, PHILADELPHIA, PA 19103-2125
(215) 563-9478
(215) 563-2301
Mailing address
1628 JOHN F KENNEDY BLVD, SUITE # 2100, PHILADELPHIA, PA 19103-2125
(215) 563-9478
(215) 563-2301

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC001390L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0032689000
PERSONAL CHOICE
PA
01
042204HUR
RENDERING PHYSICIAN PIN
PA
01
0656649000
AMERIHEALTH
NJ
01
090571
NATIONAL GOVERNMENT SERVI
NJ
01
ME042204
HIGHMARK BLUE SHIELD
PA
Enumeration date
07/10/2006
Last updated
03/10/2008
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