Individual
LAURA J LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1011 N ELMER AVE, SAYRE, PA 18840-1832
(570) 887-3070
(570) 887-3382
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD462097
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02091418
—
NY
01
—
161355553
BUSINESS TAX ID
—
Enumeration date
06/27/2006
Last updated
03/05/2021
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