Provider Demographics
NPI:1356483077
Name:LEITER, SHULAMIT (EDD)
Entity Type:Individual
Prefix:DR
First Name:SHULAMIT
Middle Name:
Last Name:LEITER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 FAWN DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1905
Mailing Address - Country:US
Mailing Address - Phone:973-994-0422
Mailing Address - Fax:
Practice Address - Street 1:21 FAWN DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1905
Practice Address - Country:US
Practice Address - Phone:973-994-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00383700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8394105Medicaid
NJ8394105Medicaid
NJ042707Medicare ID - Type Unspecified