Healthcare Provider Details

I. General information

NPI: 1205775319
Provider Name (Legal Business Name): ELIZABETH ANN LEDERER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 PENN AVE
WYOMISSING PA
19610-2148
US

IV. Provider business mailing address

1390 PARISH AVE
CLAYMONT DE
19703-3329
US

V. Phone/Fax

Practice location:
  • Phone: 610-373-3738
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: