Provider Demographics
NPI:1891063921
Name:LESLIE SOJKA, MD, PA
Entity Type:Organization
Organization Name:LESLIE SOJKA, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-462-4040
Mailing Address - Street 1:495 IRON BRIDGE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3069
Mailing Address - Country:US
Mailing Address - Phone:732-462-4040
Mailing Address - Fax:732-308-3495
Practice Address - Street 1:495 IRON BRIDGE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3069
Practice Address - Country:US
Practice Address - Phone:732-462-4040
Practice Address - Fax:732-308-3495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-04
Last Update Date:2011-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04241000261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3904601Medicaid
C54888Medicare UPIN