Provider Demographics
NPI:1003075755
Name:KUSHNIR, LEON (MD)
Entity type:Individual
Prefix:DR
First Name:LEON
Middle Name:
Last Name:KUSHNIR
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 1:1905 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3315
Mailing Address - Country:US
Mailing Address - Phone:856-285-8010
Mailing Address - Fax:
Practice Address - Street 1:4701 OGLETOWN STANTON RD STE 4200
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2075
Practice Address - Country:US
Practice Address - Phone:302-658-7533
Practice Address - Fax:302-737-7701
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-07
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0027264208600000X
NJ25MA08979400208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery