Provider Demographics
NPI:1770590283
Name:URBANSKI, LEONARD
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:URBANSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 RIVER FOREST DR
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16229-1510
Mailing Address - Country:US
Mailing Address - Phone:724-294-0060
Mailing Address - Fax:
Practice Address - Street 1:651 FOURTH AVE
Practice Address - Street 2:ALLE-KISKI MEDICAL CENTER
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068
Practice Address - Country:US
Practice Address - Phone:724-334-4710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-005167L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010051730012Medicaid
PA168942RJMMedicare ID - Type Unspecified
PA0010051730012Medicaid