Provider Demographics
NPI:1841243235
Name:LEIS, BATTISTA AND ASSOCIATES, PC
Entity Type:Organization
Organization Name:LEIS, BATTISTA AND ASSOCIATES, PC
Other - Org Name:COCOA FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:JERRY
Authorized Official - Last Name:LEIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-533-4141
Mailing Address - Street 1:1120 COCOA AVE
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-1712
Mailing Address - Country:US
Mailing Address - Phone:717-533-4141
Mailing Address - Fax:717-533-9797
Practice Address - Street 1:1120 COCOA AVE
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1712
Practice Address - Country:US
Practice Address - Phone:717-533-4141
Practice Address - Fax:717-533-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty