Provider Demographics
NPI:1770587438
Name:SAX, LEONARD (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:SAX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 OCTORARA TRAIL
Mailing Address - Street 2:
Mailing Address - City:PARKSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19365-2150
Mailing Address - Country:US
Mailing Address - Phone:610-857-6616
Mailing Address - Fax:
Practice Address - Street 1:950 OCTORARA TRAIL
Practice Address - Street 2:
Practice Address - City:PARKSBURG
Practice Address - State:PA
Practice Address - Zip Code:19365-2150
Practice Address - Country:US
Practice Address - Phone:610-857-6616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD38076207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC34124Medicare UPIN