Provider Demographics
NPI:1750524088
Name:LEARY, GEORGE EDWARD II (MA)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:EDWARD
Last Name:LEARY
Suffix:II
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:GEORGE
Other - Middle Name:EDWARD
Other - Last Name:LEARY
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1501 W SARATOGA ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-1749
Mailing Address - Country:US
Mailing Address - Phone:410-383-8300
Mailing Address - Fax:410-383-3131
Practice Address - Street 1:1501 W SARATOGA ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-1749
Practice Address - Country:US
Practice Address - Phone:410-383-8300
Practice Address - Fax:410-383-3131
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health