Doctor Name: | LEONARD CHESTER BANDALA |
NPI Number: | 1588668560 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD-043625-L |
Business Practice Address: | 400 S 9th St Lehighton, PA - 182351812 |
Business Phone Number: | 6103790443 |
Business Fax Number: | |
Mailing Address: | Po Box 62219-2219, BALTIMORE |
State: | MD |
Postal Code: | 212640001 |
Phone Number: | 2018042800 |
Fax Number: | |
NPI Enumeration Date: | 06/08/2005 |
NPI Last Update Date: | 08/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD-043625-L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |