Provider Demographics
NPI:1194566091
Name:CARRERO-TRAPP, LEANZA CECILIA (MD)
Entity type:Individual
Prefix:DR
First Name:LEANZA
Middle Name:CECILIA
Last Name:CARRERO-TRAPP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LEANZA
Other - Middle Name:CECILIA
Other - Last Name:CARRERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 SPRING GARDEN ST UNIT 202
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-2944
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8835 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-2765
Practice Address - Country:US
Practice Address - Phone:215-248-8907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT231847207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine