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Individual

DR. LEON C SIDOREK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
12 GRACE DR, SUITE 2, TUNKHANNOCK, PA 18657-9120
(570) 836-3668
(570) 836-5710
Mailing address
12 GRACE DR, STE 2, TUNKHANNOCK, PA 18657-9120
(570) 836-3668
(570) 836-5710

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC-002903-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0010088450003
PA
Enumeration date
06/27/2005
Last updated
11/19/2009
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