Provider Demographics
NPI:1578508685
Name:LEYBEL, BORIS (MD)
Entity Type:Individual
Prefix:DR
First Name:BORIS
Middle Name:
Last Name:LEYBEL
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 1:15 CEDARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2604
Mailing Address - Country:US
Mailing Address - Phone:201-797-8333
Mailing Address - Fax:201-791-7746
Practice Address - Street 1:225 BROADWAY
Practice Address - Street 2:SUITE 1012, 10TH FL.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3001
Practice Address - Country:US
Practice Address - Phone:212-790-6000
Practice Address - Fax:212-962-7770
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2001162084P2900X
NJ25MA064399002084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G27509Medicare UPIN
NYW33293Medicare PIN
NY92Z86Medicare PIN