Individual
THEO JAMES LERIOTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 E LANCASTER AVE, WYNNEWOOD, PA 19096-3450
(484) 476-2000
Mailing address
100 E LANCASTER AVE, WYNNEWOOD, PA 19096-3450
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB10112300
NJ
Other
Enumeration date
06/18/2013
Last updated
11/16/2020
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