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Individual

EDWARD C LEONARD JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124
(215) 831-4700
Mailing address
4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124
(215) 831-4700

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD008337E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0056096000
PERSONAL CHOICE
01
019338
BLUE SHIELD
PA
Enumeration date
02/21/2007
Last updated
07/08/2007
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