Provider Demographics
NPI:1477609634
Name:SOJKA, LESLIE WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:WILLIAM
Last Name:SOJKA
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 1:495 IRON BRIDGE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3069
Mailing Address - Country:US
Mailing Address - Phone:732-462-4040
Mailing Address - Fax:
Practice Address - Street 1:495 IRON BRIDGE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3069
Practice Address - Country:US
Practice Address - Phone:732-462-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA042410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3904601Medicaid
C54888Medicare UPIN
SO448362Medicare ID - Type UnspecifiedMEDICARE NUMBER