Provider Demographics
NPI:1629225776
Name:CARY H. LEIZER, DMD, PA
Entity Type:Organization
Organization Name:CARY H. LEIZER, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:LEIZER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-238-4422
Mailing Address - Street 1:C4 CORNWALL DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3352
Mailing Address - Country:US
Mailing Address - Phone:732-238-4422
Mailing Address - Fax:732-238-0866
Practice Address - Street 1:C4 CORNWALL DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3352
Practice Address - Country:US
Practice Address - Phone:732-238-4422
Practice Address - Fax:732-238-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022787001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty