Provider Demographics
NPI:1700833092
Name:LEFF, CHARLES ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ALLEN
Last Name:LEFF
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 1:1314 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3253
Mailing Address - Country:US
Mailing Address - Phone:908-754-0400
Mailing Address - Fax:908-561-7675
Practice Address - Street 1:1314 PARK AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3253
Practice Address - Country:US
Practice Address - Phone:908-754-0400
Practice Address - Fax:908-561-7675
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA02997200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD19692Medicare UPIN
NJ266103Medicare ID - Type UnspecifiedHEMATOLOGY-ONCOLOGY
NJ446916Medicare ID - Type UnspecifiedHEMATOLOGY-ONCOLOGY