Provider Demographics
NPI:1982618013
Name:BLOCK, LEONARD (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:BLOCK
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 1:280 MAIN ST
Mailing Address - Street 2:SUITE 441
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2919
Mailing Address - Country:US
Mailing Address - Phone:603-577-3160
Mailing Address - Fax:603-577-3199
Practice Address - Street 1:280 MAIN ST
Practice Address - Street 2:SUITE 441
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2919
Practice Address - Country:US
Practice Address - Phone:603-577-3160
Practice Address - Fax:603-577-3199
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6804208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0102361Y0NH03OtherANTHEM
NH006804OtherTUFTS
NHB72924OtherHARVARD PILGRIM HEALTH
NH30203683Medicaid
NH35040OtherCIGNA HEALTHCARE
NHB72924OtherHARVARD PILGRIM HEALTH
NH9748Medicare ID - Type Unspecified