Provider Demographics
NPI:1568499473
Name:LEFF, ALISON JOY (DO)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:JOY
Last Name:LEFF
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 1:300 E LANCASTER AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2139
Mailing Address - Country:US
Mailing Address - Phone:610-642-2002
Mailing Address - Fax:610-642-7607
Practice Address - Street 1:300 E LANCASTER AVE STE 400
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-2139
Practice Address - Country:US
Practice Address - Phone:610-642-2002
Practice Address - Fax:610-642-7607
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013095207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008017181Medicaid
I07541Medicare UPIN
CTD400020362Medicare PIN