Healthcare Provider Details

I. General information

NPI: 1386970069
Provider Name (Legal Business Name): MARIA LEPORE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2009
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

656 E SWEDESFORD RD
WAYNE PA
19087-1606
US

IV. Provider business mailing address

656 E SWEDESFORD RD
WAYNE PA
19087-1606
US

V. Phone/Fax

Practice location:
  • Phone: 888-321-2170
  • Fax:
Mailing address:
  • Phone: 888-321-2170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberSP010444
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: