| Doctor Name: | DR. LEON C SIDOREK |
| NPI Number: | 1336145085 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | SC-002903-L |
| Business Practice Address: | 12 Grace Dr Suite 2 Tunkhannock, PA - 186579120 |
| Business Phone Number: | 5708363668 |
| Business Fax Number: | 5708365710 |
| Mailing Address: | 12 Grace Dr, Ste 2 TUNKHANNOCK |
| State: | PA |
| Postal Code: | 186579120 |
| Phone Number: | 5708363668 |
| Fax Number: | 5708365710 |
| NPI Enumeration Date: | 06/27/2005 |
| NPI Last Update Date: | 11/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | SC-002903-L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |