Provider Demographics
NPI:1578535860
Name:ENDE, LEIGH S (MD)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:S
Last Name:ENDE
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 1:715 STATE HIGHWAY 10
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2025
Mailing Address - Country:US
Mailing Address - Phone:973-366-5565
Mailing Address - Fax:973-361-2308
Practice Address - Street 1:715 STATE ROUTE 10
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2025
Practice Address - Country:US
Practice Address - Phone:973-366-5565
Practice Address - Fax:973-361-2308
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA037687174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist