Provider Demographics
NPI:1124028774
Name:DALAL, LEENA B (MD)
Entity Type:Individual
Prefix:DR
First Name:LEENA
Middle Name:B
Last Name:DALAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:AGH PEDIATRICS
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3157
Mailing Address - Fax:412-359-3663
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:AGH PEDIATRICS
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3157
Practice Address - Fax:412-359-3663
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035120L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810008428Medicaid
PA0009115130005Medicaid
OH2331588Medicaid
PA130891NJBMedicare PIN