Provider Demographics
NPI:1619986809
Name:LEAFF, LOUIS ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:ARTHUR
Last Name:LEAFF
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 1:405 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2724
Mailing Address - Country:US
Mailing Address - Phone:610-664-7465
Mailing Address - Fax:610-664-2429
Practice Address - Street 1:555 E CITY AVE
Practice Address - Street 2:520
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1115
Practice Address - Country:US
Practice Address - Phone:610-667-2899
Practice Address - Fax:610-664-2429
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00024792084P0800X
PAMD008903E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA019231Medicare ID - Type Unspecified
DE19975Medicare UPIN
PA19975Medicare UPIN
DE019231Medicare ID - Type Unspecified