Provider Demographics
NPI:1073610770
Name:NEUBAUER, LEON MILES (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:MILES
Last Name:NEUBAUER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 KINGS HWY N
Mailing Address - Street 2:STE 303
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1912
Mailing Address - Country:US
Mailing Address - Phone:856-546-3040
Mailing Address - Fax:856-616-1172
Practice Address - Street 1:408 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1311
Practice Address - Country:US
Practice Address - Phone:856-607-7325
Practice Address - Fax:856-616-1172
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA015409103TC0700X
NJ4276103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical