1437192101 NPI number — MR. LEON H VENIER MD

Table of content: MR. LEON H VENIER MD (NPI 1437192101)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437192101 NPI number — MR. LEON H VENIER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VENIER
Provider First Name:
LEON
Provider Middle Name:
H
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437192101
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2209 QUARRY DRIVE
Provider Second Line Business Mailing Address:
SUITE B 24
Provider Business Mailing Address City Name:
WEST LAWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-927-9366
Provider Business Mailing Address Fax Number:
610-927-9368

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2209 QUARRY DRIVE
Provider Second Line Business Practice Location Address:
SUITE B 24
Provider Business Practice Location Address City Name:
WEST LAWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-927-9366
Provider Business Practice Location Address Fax Number:
610-927-9368
Provider Enumeration Date:
06/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  MD011237E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 53455 . This is a "AETNA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01151001 . This is a "CAPITAL BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0989087000 . This is a "INDEPENDENCE BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0020380000 . This is a "KEYSTONE EAST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01151001 . This is a "KEYSTONE HEALTH PLAN CENT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1451088001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 032503 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".




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