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Individual

ALONSO E. CONCHA LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1925 PACIFIC AVE, ATLANTIC CITY, NJ 08401-6713
(609) 345-4000
(609) 572-8523
Mailing address
100 E PENN SQ, 9TH FL, PHILADELPHIA, PA 19107-3323
(267) 425-9234
(267) 425-9299

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MA08140100
NJ
208000000X
Pediatrics Physician
Primary
MD429937
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1020803440008
PA
Enumeration date
09/27/2006
Last updated
12/02/2018
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