Provider Demographics
NPI:1902843691
Name:DRS. LEO W.TODD, JR. & GREGORY S. TODD
Entity Type:Organization
Organization Name:DRS. LEO W.TODD, JR. & GREGORY S. TODD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-437-3934
Mailing Address - Street 1:2428 WALBERT AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-1350
Mailing Address - Country:US
Mailing Address - Phone:610-437-3934
Mailing Address - Fax:610-437-5180
Practice Address - Street 1:2428 WALBERT AVE
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-1350
Practice Address - Country:US
Practice Address - Phone:610-437-3934
Practice Address - Fax:610-437-5180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1353218OtherHIGHMARK BLUE SHIELD
PA02357600OtherCAPITAL BLUE CROSS
PA058583Medicare ID - Type Unspecified