| NPI | 1497904049 |
|---|---|
| Other Name | JEANES FAMILY PRACTICE - MARA LEYZIN, MD |
| Entity Type | Organization |
| Authorized Contact | ERIC MANKIN Chief Executive Officer 215-926-9050 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-30 |