Provider Demographics
NPI:1497783609
Name:FERRARA, LEONARD PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:PETER
Last Name:FERRARA
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 1:815 NORMAN DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7445
Mailing Address - Country:US
Mailing Address - Phone:717-272-4500
Mailing Address - Fax:717-270-4378
Practice Address - Street 1:815 NORMAN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7445
Practice Address - Country:US
Practice Address - Phone:717-272-4500
Practice Address - Fax:717-270-4378
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039340E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001665236OtherHIGHMARK BLUE SHIELD
PA001198089004Medicaid
PA01699901OtherCAPITAL BLUE CROSS
PA001665236OtherHIGHMARK BLUE SHIELD
PA001198089004Medicaid