Provider Demographics
NPI:1437118544
Name:UNGERLEIDER, DEBORAH L (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:L
Last Name:UNGERLEIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 GODWIN AVE
Mailing Address - Street 2:SUITE #100
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1969
Mailing Address - Country:US
Mailing Address - Phone:201-444-8389
Mailing Address - Fax:201-444-2309
Practice Address - Street 1:44 GODWIN AVE
Practice Address - Street 2:SUITE #100
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1969
Practice Address - Country:US
Practice Address - Phone:201-444-8389
Practice Address - Fax:201-444-2309
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA52897174400000X
NJ25MA05289700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist