Provider Demographics
NPI:1114940210
Name:LESHNER, RICHARD TERRENCE (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:TERRENCE
Last Name:LESHNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 BIG OAK RD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-6421
Mailing Address - Country:US
Mailing Address - Phone:215-750-6657
Mailing Address - Fax:215-860-3348
Practice Address - Street 1:1690 BIG OAK RD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-6421
Practice Address - Country:US
Practice Address - Phone:215-750-6657
Practice Address - Fax:215-860-3348
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004448L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1046176Medicaid
PA1046176Medicaid
PA438815KC3Medicare PIN