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Individual

LEONARD CHESTER BANDALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
400 S 9TH ST, LEHIGHTON, PA 18235-1812
(610) 379-0443
Mailing address
PO BOX 62219-2219, BALTIMORE, MD 21264-0001
(201) 804-2800

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD-043625-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1231693
PA
Enumeration date
06/08/2005
Last updated
08/04/2008
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