MEDICARE: DR. LEONARD BIELORY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KI0005X	Clinical & Laboratory Immunology (Allergy & Immunology) Physician	25MA04594700	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154352987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD BIELORY M.D.

Provider Business Mailing Address
First Line	:	400 MOUNTAIN AVE
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-2515
Country	:	US
Telephone Number	:	973-912-9817
Fax Number	:	206-333-1884

Provider Business Practice Location Address
First Line	:	400 MOUNTAIN AVE
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-2515
Country	:	US
Telephone Number	:	973-912-9817
Fax Number	:	206-333-1884

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	05/20/2011

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