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Organization
MARA LEYZIN, MD, PC
Active
Organization
MARA LEYZIN, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARA LEYZIN MD (PRESIDENT/SOLO PRACTITIONER)
(215) 745-9900
Entity
Organization
Contact information
Practice address
8025 CASTOR AVE, PHILA, PA 19152-2733
(215) 745-9900
(215) 745-9902
Mailing address
8025 CASTOR AVE, PHILA, PA 19152-2733
(215) 745-9900
(215) 745-9902
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-032043-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102634086000
—
PA
Enumeration date
10/23/2012
Last updated
10/23/2012
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