MEDICARE: DR. LAWRENCE J LEVENTHAL 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	207RR0500X	Rheumatology Physician	MD034222E	PA

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	:	1174521165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE J LEVENTHAL M.D.

Provider Business Mailing Address
First Line	:	727 WELSH RD
Second Line	:	SUITE 201
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006-6310
Country	:	US
Telephone Number	:	215-947-8701
Fax Number	:	215-947-9704

Provider Business Practice Location Address
First Line	:	727 WELSH RD
Second Line	:	SUITE 201
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006-6310
Country	:	US
Telephone Number	:	215-947-8701
Fax Number	:	215-947-9704

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	03/29/2021

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