Provider Demographics
NPI:1689694242
Name:DENBLEYKER, LEONARD ANTHONY (DPM)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:ANTHONY
Last Name:DENBLEYKER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HURON AVE
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3641
Mailing Address - Country:US
Mailing Address - Phone:201-963-0100
Mailing Address - Fax:201-963-0716
Practice Address - Street 1:10 HURON AVE
Practice Address - Street 2:SUITE 1G
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3641
Practice Address - Country:US
Practice Address - Phone:201-963-0100
Practice Address - Fax:201-963-0716
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001624213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1921801Medicaid
NJ1095040001Medicare NSC
NJ1921801Medicaid
NJ455173Medicare PIN