Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 38MC00720000 | NJ |
N | 111N00000X | Chiropractor | 70012740 | NY |
N | 111NR0400X | Rehabilitation Chiropractor | 38MC00720000 | NJ |
NPI | 1215334461 |
---|---|
Provider Name | Matthew Leffel |
First Address | Hackensack, NJ 07601-7128 |
Second Address | Hackensack, NJ 07601-6116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2014 |
Last Update Date | 22/07/2019 |