Provider Demographics
NPI:1912912692
Name:LEEDER, ASHER Z (DC)
Entity Type:Individual
Prefix:DR
First Name:ASHER
Middle Name:Z
Last Name:LEEDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 COMMONWEALTH AVE
Mailing Address - Street 2:SUITE2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-4638
Mailing Address - Country:US
Mailing Address - Phone:617-739-0046
Mailing Address - Fax:617-738-9441
Practice Address - Street 1:1216 COMMONWEALTH AVE
Practice Address - Street 2:SUITE2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-4638
Practice Address - Country:US
Practice Address - Phone:617-739-0046
Practice Address - Fax:617-738-9441
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35476Medicare ID - Type Unspecified
MAU33307Medicare UPIN