Provider Demographics
NPI:1073529319
Name:WAICE, LEONARD A (DO)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:A
Last Name:WAICE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:WACHUSETT FAMILY PRACTICE
Mailing Address - Street 2:52 BOYDEN ROAD, SUITE 209
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520
Mailing Address - Country:US
Mailing Address - Phone:508-829-4351
Mailing Address - Fax:
Practice Address - Street 1:WACHUSETT FAMILY PRACTICE
Practice Address - Street 2:52 BOYDEN ROAD, STE 209
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520
Practice Address - Country:US
Practice Address - Phone:508-829-4351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA78919207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine