Provider Demographics
NPI:1740341569
Name:LEOPOLD, NORMAN A (DO)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:A
Last Name:LEOPOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 533
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:610-874-1184
Mailing Address - Fax:610-872-4258
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 533
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3902
Practice Address - Country:US
Practice Address - Phone:610-874-1184
Practice Address - Fax:610-872-4258
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS003201L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000646263Medicaid
PAB40725Medicare UPIN
PA000646263Medicaid