Provider Demographics
NPI:1992747422
Name:LEADER SURGICAL ASSOCIATES
Entity type:Organization
Organization Name:LEADER SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VASUDEVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIRUCHELVAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-741-3449
Mailing Address - Street 1:25 MONUMENT RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5060
Mailing Address - Country:US
Mailing Address - Phone:717-741-3449
Mailing Address - Fax:717-741-5496
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:SUITE 260
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5060
Practice Address - Country:US
Practice Address - Phone:717-741-3449
Practice Address - Fax:717-741-5496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA032636Medicare ID - Type Unspecified