Provider Demographics
NPI:1851634190
Name:DOHERTY, LEANA (MD)
Entity Type:Individual
Prefix:
First Name:LEANA
Middle Name:
Last Name:DOHERTY
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 1:12680 PERRY HWY FL 2
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8886
Mailing Address - Country:US
Mailing Address - Phone:412-748-5543
Mailing Address - Fax:412-367-2725
Practice Address - Street 1:12680 PERRY HWY FL 2
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8886
Practice Address - Country:US
Practice Address - Phone:412-748-5543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4740352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology