Provider Demographics
NPI:1942264874
Name:CHARNEY, LEAH M (DC)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:M
Last Name:CHARNEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LEAH
Other - Middle Name:M
Other - Last Name:KUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3076 EAGLE VALLEY RD.
Mailing Address - Street 2:
Mailing Address - City:MILL HALL
Mailing Address - State:PA
Mailing Address - Zip Code:17751-1626
Mailing Address - Country:US
Mailing Address - Phone:570-726-2000
Mailing Address - Fax:570-726-8012
Practice Address - Street 1:3076 EAGLE VALLEY RD.
Practice Address - Street 2:
Practice Address - City:MILL HALL
Practice Address - State:PA
Practice Address - Zip Code:17751-1626
Practice Address - Country:US
Practice Address - Phone:570-726-2000
Practice Address - Fax:570-726-8012
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009328111N00000X
PAAJ009137111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1657365OtherBCBS
PA101128775-0001Medicaid
PA101128775-0001Medicaid