Individual
MR. CRAIG PAUL LEONARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
2869 HOLME AVE, PHILADELPHIA, PA 19152-2118
(215) 676-4070
(215) 676-4071
Mailing address
1585 WILLOW POND DR, YARDLEY, PA 19067-5793
(215) 676-4070
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT008976L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045559PRL
MEDICARE ID
PA
01
—
2004000000
KEYSTONE HEALTH PLAN EAST
PA
01
—
2563889
AETNA/ US HEALTH CARE
PA
01
—
PA BLUE SHIELD
1311180
PA
Enumeration date
07/25/2006
Last updated
11/15/2007
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