Provider Demographics
NPI:1770589087
Name:WINEGRAD, LEONARD A (DO)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:A
Last Name:WINEGRAD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 DAVISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-3332
Mailing Address - Country:US
Mailing Address - Phone:215-659-8967
Mailing Address - Fax:
Practice Address - Street 1:221 DAVISVILLE RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-3332
Practice Address - Country:US
Practice Address - Phone:215-659-8967
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002463L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA041879Medicare ID - Type Unspecified