Provider Demographics
NPI:1871657767
Name:LEIFER, MARVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:
Last Name:LEIFER
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 1:42 N TULANE ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-6912
Mailing Address - Country:US
Mailing Address - Phone:609-497-1810
Mailing Address - Fax:609-683-7929
Practice Address - Street 1:42 N TULANE ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08542-6912
Practice Address - Country:US
Practice Address - Phone:609-497-1810
Practice Address - Fax:609-683-7929
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA561132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry