Basic Information
| Provider Information | |||||||||
| NPI: | 1255793287 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEPERE | ||||||||
| FirstName: | DARREN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2580 HAYMAKER RD STE 304 | ||||||||
| Address2: | |||||||||
| City: | MONROEVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151463500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123594352 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2580 HAYMAKER RD STE 304 | ||||||||
| Address2: | |||||||||
| City: | MONROEVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151463500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123594352 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2016 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | MD467961 | PA | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 15684868 | 01 | CAQH | OTHER |