Provider Demographics
NPI:1154320224
Name:LEONI, JOSEPH V (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:V
Last Name:LEONI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 BROADCASTING RD
Mailing Address - Street 2:STE 200
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3222
Mailing Address - Country:US
Mailing Address - Phone:610-372-8995
Mailing Address - Fax:
Practice Address - Street 1:1320 BROADCASTING RD
Practice Address - Street 2:STE 200
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3222
Practice Address - Country:US
Practice Address - Phone:610-372-8995
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012138E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01515302OtherCAPITAL BC
PA082883OtherHIGHMARK BS
PA082883Medicare ID - Type Unspecified
PA01515302OtherCAPITAL BC