Provider Demographics
NPI:1073518395
Name:ADLER, LEROY P (MD)
Entity Type:Individual
Prefix:DR
First Name:LEROY
Middle Name:P
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LEE
Other - Middle Name:P
Other - Last Name:ADLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:261 OLD YORK RD
Mailing Address - Street 2:STE 106
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-3706
Mailing Address - Country:US
Mailing Address - Phone:215-935-0030
Mailing Address - Fax:215-935-0023
Practice Address - Street 1:261 OLD YORK RD
Practice Address - Street 2:STE 106
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3706
Practice Address - Country:US
Practice Address - Phone:215-887-2102
Practice Address - Fax:215-887-0525
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029568E207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018602680002Medicaid
PAE29638Medicare UPIN
PA0018602680002Medicaid