Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 021804 | PR |
Y | 2080P0214X | Pediatric Pulmonologist | MT222161 | PA |
NPI | 1457871485 |
---|---|
Provider Name | Cynara Leon |
First Address | Philadelphia, PA 19103-5142 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2017 |
Last Update Date | 18/06/2021 |