Provider Demographics
NPI:1255421624
Name:LEBDER, LEAH M (RD, LDN, CDCES)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:M
Last Name:LEBDER
Suffix:
Gender:F
Credentials:RD, LDN, CDCES
Other - Prefix:MISS
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:SANT'EUFEMIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-0004
Mailing Address - Country:US
Mailing Address - Phone:724-601-0159
Mailing Address - Fax:
Practice Address - Street 1:110 AMY DR
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-1415
Practice Address - Country:US
Practice Address - Phone:724-601-0159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002987133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA091668UA2Medicare ID - Type Unspecified