MEDICARE: MISS STEPHANIE JO LESLIE PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT023037	PA

General Provider Information

NPI Number	:	1932608775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS STEPHANIE JO LESLIE PT, DPT

Provider Business Mailing Address
First Line	:	3719 PALISADES DR
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19129-1764
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 W CARSON ST STE 200
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-1031
Country	:	US
Telephone Number	:	520-874-2391
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2018
Last Update Date	:	03/27/2026

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