Provider Demographics
NPI:1073586871
Name:LEFF, STEVEN R (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:LEFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PROSPECT ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5020
Mailing Address - Country:US
Mailing Address - Phone:732-367-0699
Mailing Address - Fax:
Practice Address - Street 1:101 PROSPECT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5020
Practice Address - Country:US
Practice Address - Phone:732-367-0699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA47638207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0798606Medicaid
D06957Medicare UPIN
NJ0798606Medicaid
167361Medicare UPIN