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General NPI Number Information
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NPI Number | 1558391565
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Entity Type | Organization
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Legal Business Name | LEONARD MENAKER
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 1628 JOHN F KENNEDY BLVD SUITE # 2100
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City | PHILADELPHIA
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State | PA
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Zip | 19103-2125
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Country | US
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Telephone | 215-563-9478
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Fax | 215-563-2301
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Provider Business Mailing Address
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Address Line | 1628 JOHN F KENNEDY BLVD SUITE # 2100
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City | PHILADELPHIA
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State | PA
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Zip | 19103-2125
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Country | US
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Telephone | 215-563-9478
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Fax | 215-563-2301
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEONARD MENAKER
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Credential | D.P.M.
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Telephone | 215-563-9478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC001390L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | SC001390L
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License Number State | PA
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