Individual
DR. JEANNE LLENADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3 CRESCENT DR FL 2, PHILADELPHIA, PA 19112-1016
(215) 503-7124
(215) 503-3191
Mailing address
3 CRESCENT DR FL 2, PHILADELPHIA, PA 19112-1016
(215) 503-7124
(215) 503-3191
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
OS-011077-L
PA
208800000X
Urology Physician
25MB06433200
NJ
208800000X
Urology Physician
Primary
OS-011077-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001853497
—
PA
05
—
8536201
—
NJ
Enumeration date
07/14/2006
Last updated
12/31/2018
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