Provider Demographics
NPI:1124296009
Name:LEIGHT, KRISTIN L (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:L
Last Name:LEIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:LEIGHT
Other - Last Name:WESLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3535 MARKET STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-7119
Mailing Address - Fax:212-543-5356
Practice Address - Street 1:3535 MARKET STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-7119
Practice Address - Fax:212-543-5356
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4532852084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry