Provider Demographics
NPI:1912178989
Name:ROBERT J LEON M D P C
Entity Type:Organization
Organization Name:ROBERT J LEON M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-610-1535
Mailing Address - Street 1:129 WASHINGTON ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4657
Mailing Address - Country:US
Mailing Address - Phone:201-610-1535
Mailing Address - Fax:201-610-1578
Practice Address - Street 1:129 WASHINGTON ST
Practice Address - Street 2:SUITE 401
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4657
Practice Address - Country:US
Practice Address - Phone:201-610-1535
Practice Address - Fax:201-610-1578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ65906207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7596600Medicaid
NJ011603Medicare PIN
NJ7596600Medicaid
F81437Medicare UPIN