MEDICARE: DR. LEO ZACHARIAS MD

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	207R00000X	Internal Medicine Physician	MD050467	PA

General Provider Information

NPI Number	:	1346221777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEO ZACHARIAS MD

Provider Business Mailing Address
First Line	:	41 UNIVERSITY DR STE 106
Second Line	:
City	:	NEWTOWN
State	:	PA
Zip	:	18940-1873
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 LANSDOWNE AVE FL MOB1
Second Line	:
City	:	DARBY
State	:	PA
Zip	:	19023-1333
Country	:	US
Telephone Number	:	610-534-6310
Fax Number	:

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

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	05/19/2021

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