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Individual
DR. VICKY LEO
Active
Individual
DR. VICKY LEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS008408L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013011
GATEWAY
PA
01
—
393977
MEDICARE
PA
01
—
598349
BLUE SHIELD
PA
01
—
70996
UNISON
PA
01
—
F27496
HEALTH AMERICA
PA
01
—
OS008408L
PA STATE LICENSE NUMBER
PA
Enumeration date
02/20/2007
Last updated
07/08/2007
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