Provider Demographics
NPI:1417747064
Name:HARMON, LEONARD B
Entity type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:B
Last Name:HARMON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 SW CUTOFF RM 116
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2126
Mailing Address - Country:US
Mailing Address - Phone:617-877-9779
Mailing Address - Fax:617-830-9444
Practice Address - Street 1:380 SW CUTOFF RM 116
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-2126
Practice Address - Country:US
Practice Address - Phone:617-877-9779
Practice Address - Fax:617-830-9444
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS275647573747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant