MEDICARE: DR. BARTLOMIEJ TOMASZ LEYKO MD

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	207K00000X	Allergy & Immunology Physician	32617	AZ

General Provider Information

NPI Number	:	1538124946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARTLOMIEJ TOMASZ LEYKO MD

Provider Business Mailing Address
First Line	:	300 W CLARENDON AVE
Second Line	:	STE 120
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3421
Country	:	US
Telephone Number	:	602-277-3337
Fax Number	:	602-277-3330

Provider Business Practice Location Address
First Line	:	300 W CLARENDON AVE
Second Line	:	STE 120
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3421
Country	:	US
Telephone Number	:	602-277-3337
Fax Number	:	602-277-3330

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	07/08/2007

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