Individual
LEONARDO GENDZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
34TH STREET & CIVIC CENTER BLVD, SUITE 9329, PHILADELPHIA, PA 19104-4399
(215) 590-1858
(215) 590-1415
Mailing address
100 E PENN SQ, THE WANAMAKER BUILDING, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9300
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
E-3860
AR
207LP3000X
Pediatric Anesthesiology Physician
Primary
MD420963
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116190EJL
MEDICARE PTAN
PA
05
—
154676001
—
AR
Enumeration date
10/13/2006
Last updated
03/29/2013
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