Provider Demographics
NPI:1881034841
Name:PATEL, LEEZA (MD)
Entity Type:Individual
Prefix:DR
First Name:LEEZA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LEEZA
Other - Middle Name:
Other - Last Name:NAYYAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3317 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2558
Mailing Address - Country:US
Mailing Address - Phone:814-868-8531
Mailing Address - Fax:
Practice Address - Street 1:3317 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508
Practice Address - Country:US
Practice Address - Phone:814-868-8531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-04
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD463834207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology