Basic Information
| Provider Information | |||||||||
| NPI: | 1982965604 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEONG | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 160 E ERIE AVE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191341011 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 WOODS RD | ||||||||
| Address2: | |||||||||
| City: | VALHALLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144938558 | ||||||||
| FaxNumber: | 9144931488 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2012 | ||||||||
| LastUpdateDate: | 07/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MT201798 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | MD454014 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 294606 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.