Provider Demographics
NPI:1649249582
Name:LEIBU, TONEL (MD)
Entity type:Individual
Prefix:DR
First Name:TONEL
Middle Name:
Last Name:LEIBU
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 1:16 ARCADIAN WAY
Mailing Address - Street 2:SUITE C3
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1291
Mailing Address - Country:US
Mailing Address - Phone:201-843-4110
Mailing Address - Fax:201-843-8810
Practice Address - Street 1:16 ARCADIAN WAY
Practice Address - Street 2:SUITE C3
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1291
Practice Address - Country:US
Practice Address - Phone:201-843-4110
Practice Address - Fax:201-843-8810
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA067592207R00000X
NY211102207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH04258Medicare UPIN
NY797181Medicare ID - Type Unspecified
NYH04258Medicare UPIN
NJ046662Medicare ID - Type Unspecified