Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 13429 | NJ |
NPI | 1114910809 |
---|---|
Provider Name | Dr. Leslie Elfenbein |
First Address | Clifton, NJ 07013-3586 |
Second Address | Clifton, NJ 07013-3586 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 08/07/2007 |