Provider Demographics
NPI:1437222429
Name:ANTHONY J LEONE MD
Entity Type:Organization
Organization Name:ANTHONY J LEONE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-428-8006
Mailing Address - Street 1:807 HADDON AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1749
Mailing Address - Country:US
Mailing Address - Phone:856-428-8006
Mailing Address - Fax:856-795-4645
Practice Address - Street 1:807 HADDON AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1749
Practice Address - Country:US
Practice Address - Phone:856-428-8006
Practice Address - Fax:856-795-4645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9105603Medicaid
NJCK3771OtherRAILROAD MEDICARE
NJCK3771OtherRAILROAD MEDICARE