Individual
NEVIN LEIBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-6666
(215) 456-8502
Mailing address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS018712
PA
390200000X
Student in an Organized Health Care Education/Training Program
OT015169
PA
Other
Enumeration date
06/04/2013
Last updated
03/17/2018
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