Provider Demographics
NPI:1235131129
Name:LEFKOE, ROY THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:THOMAS
Last Name:LEFKOE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E CITY AVE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1708
Mailing Address - Country:US
Mailing Address - Phone:610-667-4403
Mailing Address - Fax:610-667-4078
Practice Address - Street 1:301 E CITY AVE
Practice Address - Street 2:SUITE 235
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1708
Practice Address - Country:US
Practice Address - Phone:610-667-4403
Practice Address - Fax:610-667-4078
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013015E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB33870Medicare UPIN
PA32504Medicare ID - Type UnspecifiedMEDICARE NUMBER