Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 25MA08979400 | NJ |
Y | 208600000X | Surgeon | 25MA08979400 | NJ |
NPI | 1003075755 |
---|---|
Provider Name | Dr. Leon Kushnir |
First Address | Cherry Hill, NJ 08003-3315 |
Second Address | Vineland, NJ 08360-5002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2008 |
Last Update Date | 10/09/2012 |