Individual
AMY LEIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 INDUSTRIAL BLVD STE 200, PAOLI, PA 19301-1605
(610) 647-4161
Mailing address
176 S NEW MIDDLETOWN RD STE 203, MEDIA, PA 19063-5255
(610) 566-7300
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
0116026680
VA
207N00000X
Dermatology Physician
Primary
MD460475
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT203560
PA
Other
Enumeration date
05/09/2013
Last updated
12/27/2023
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