Basic Information
| Provider Information | |||||||||
| NPI: | 1649680828 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEAP | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 BROOKS LN STE 180 | ||||||||
| Address2: | |||||||||
| City: | CLAIRTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150253769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124693600 | ||||||||
| FaxNumber: | 4124693630 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 BROOKS LN STE 180 | ||||||||
| Address2: | |||||||||
| City: | JEFFERSON HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150253769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127291500 | ||||||||
| FaxNumber: | 4123842462 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2014 | ||||||||
| LastUpdateDate: | 09/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | OS018590 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 390200000X | PA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.