Provider Demographics
NPI:1083364814
Name:LE, MARILYN KIM (DO)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:KIM
Last Name:LE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 DEKALB PIKE STE 202
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1852
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2705 DEKALB PIKE STE 202
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-1852
Practice Address - Country:US
Practice Address - Phone:610-275-7240
Practice Address - Fax:610-275-0633
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program