Provider Demographics
NPI:1659342277
Name:LEITNER, ROBYN R (MD)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:R
Last Name:LEITNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:S
Other - Last Name:ROSENKOPF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2401 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1101
Mailing Address - Country:US
Mailing Address - Phone:732-223-7877
Mailing Address - Fax:732-223-7151
Practice Address - Street 1:2401 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1101
Practice Address - Country:US
Practice Address - Phone:732-223-7877
Practice Address - Fax:732-223-7151
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07940000208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ09539DTSMedicare PIN
NJ901572Medicare ID - Type UnspecifiedMEDICARE GROUP ID
NJI44159Medicare UPIN