Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD465089 | PA |
N | 207RA0201X | Internist - Allergy & Immunology | MD465089 | PA |
NPI | 1417393273 |
---|---|
Provider Name | Lyvia Y. Leigh |
First Address | Lewes, DE 19958-7316 |
Second Address | Blue Bell, PA 19422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2013 |
Last Update Date | 25/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1035216590001 | (05) | PA |