Active NPI
Lebanon
- PACE Provider Organization
- Lebanon, PA
National Provider Identifier
1871428474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- PACE Provider Organization
- Legal business name
- LEBANON
- Practice address
- 113 S 9TH St
Lebanon, PA 17042-5108 - Phone
- (717) 376-1133
- NPI assigned
- Jun 15, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ryan Leahy
- Title
- Chief Financial Officer
- Phone
- (845) 235-6531
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| PACE Provider Organization | 251T00000X | Primary |
Addresses
Primary practice location
113 S 9TH St
Lebanon, PA 17042-5108
Mailing address
225 Crossways Park Dr
Woodbury, NY 11797-2083
National Provider Directory
National Provider DirectoryLocations
225 Crossways Park Dr
Woodbury, NY 11797
Phone (516) 422-7817
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781481600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1781481600000",
"number": "1871428474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 CROSSWAYS PARK DR",
"city": "WOODBURY",
"state": "NY",
"postal_code": "117972083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 S 9TH ST",
"city": "LEBANON",
"state": "PA",
"postal_code": "170425108",
"telephone_number": "717-376-1133"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEBANON",
"organizational_subpart": "NO",
"enumeration_date": "2026-06-15",
"last_updated": "2026-06-15",
"certification_date": "2026-06-15",
"status": "A",
"authorized_official_last_name": "LEAHY",
"authorized_official_first_name": "RYAN",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "845-235-6531"
},
"taxonomies": [
{
"code": "251T00000X",
"taxonomy_group": "",
"desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lebanon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.