Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | MD01189 | NJ |
Y | 222Z00000X | Podiatrist | MD01189 | NJ |
N | 213EP1101X | Primary Podiatric Medicine | MD01189 | NJ |
NPI | 1003883257 |
---|---|
Provider Name | Dr. Richard I Lebovic |
First Address | East Brunswick, NJ 08816-6117 |
Second Address | Linden, NJ 07036-4151 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 27/07/2007 |