Provider Demographics
NPI:1538249263
Name:FIRER, LEONARD I (MD)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:I
Last Name:FIRER
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 1:17 GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-6807
Mailing Address - Country:US
Mailing Address - Phone:781-209-0164
Mailing Address - Fax:
Practice Address - Street 1:280 BEACH ST
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-3143
Practice Address - Country:US
Practice Address - Phone:781-289-5057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226608208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics