Individual
DR. LEONA ALICE VELICOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
3445 ST VINCENT ST, PHILADELPHIA, PA 19149-1627
(215) 338-2444
(215) 708-5000
Mailing address
3445 ST VINCENT ST, PHILADELPHIA, PA 19149-1627
(215) 338-2444
(215) 708-5000
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC001964L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060668000
BLUE SHIELD
PA
05
—
007047608-0004
—
PA
05
—
007047608-0005
—
PA
05
—
007047608-0006
—
PA
05
—
007047608-0008
—
PA
05
—
007047608-0009
—
PA
Enumeration date
07/27/2006
Last updated
04/21/2020
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