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General NPI Number Information
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NPI Number | 1326369018
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Entity Type | Individual
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Provider Name | AMANDA KAE LEONBERG-YOO MD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 3400 SPRUCE STREET 1 FOUNDERS, RENAL
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 215-662-2638
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 SPRUCE STREET 1 FOUNDERS, RENAL
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 215-662-2638
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD458822
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License Number State | PA
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