Individual
LESLY PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
215 BULLENS LN STE 200, WOODLYN, PA 19094-2001
(610) 203-7566
Mailing address
215 BULLENS LN STE 200, WOODLYN, PA 19094-2001
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
825244015
IRS
PA
Enumeration date
04/19/2018
Last updated
04/19/2018
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