Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 25MA04270600 | NJ |
NPI | 1396810214 |
---|---|
Provider Name | Donald N. Leibner |
First Address | East Brunswick, NJ 08816-5426 |
Second Address | East Brunswick, NJ 08816-5426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 08/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A64407 | (02) | NJ |