Provider Demographics
NPI:1760707525
Name:GEORGE LEIPSNER, M.D., P.A.
Entity Type:Organization
Organization Name:GEORGE LEIPSNER, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEIPSNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-488-2111
Mailing Address - Street 1:57 W PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1334
Mailing Address - Country:US
Mailing Address - Phone:201-488-2111
Mailing Address - Fax:201-845-5033
Practice Address - Street 1:57 W PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1334
Practice Address - Country:US
Practice Address - Phone:201-488-2111
Practice Address - Fax:201-845-5033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ176345Medicare PIN
NJC53885Medicare UPIN