Provider Demographics
NPI:1649331521
Name:DEFIORE, LEONARD (CMT)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:DEFIORE
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 ELWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-1813
Mailing Address - Country:US
Mailing Address - Phone:609-405-8372
Mailing Address - Fax:
Practice Address - Street 1:1301 BLACK HORSE PIKE RT. 168
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012
Practice Address - Country:US
Practice Address - Phone:609-405-8372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor