Individual
DR. THOMAS P. LEIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 WALNUT ST, 2ND FLOOR, PHILADELPHIA, PA 19107-5509
(215) 955-6871
(215) 503-2990
Mailing address
900 WALNUT ST, 2ND FLOOR, PHILADELPHIA, PA 19107-5509
(215) 955-6871
(215) 503-2990
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD-070815-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001814935
—
PA
05
—
8294003
—
NJ
Enumeration date
07/21/2006
Last updated
05/16/2014
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