Healthcare Provider Details

I. General information

NPI: 1609830520
Provider Name (Legal Business Name): JOEL P LEBED D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 05/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 OLD YORK RD SUITE 3-108
JENKINTOWN PA
19046-3606
US

IV. Provider business mailing address

100 OLD YORK RD SUITE 3-108
JENKINTOWN PA
19046-3606
US

V. Phone/Fax

Practice location:
  • Phone: 215-885-5600
  • Fax: 215-885-1721
Mailing address:
  • Phone: 215-885-5600
  • Fax: 215-885-1721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberOS003518L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: