| Robin Ellen Leder, M.d., L.l.c. | |
|
235 Prospect Ave Suite Lb Hackensack NJ 07601-2510 | |
| (201) 525-1155 | |
| Not Available |
| Full Name | Robin Ellen Leder, M.d., L.l.c. |
|---|---|
| Speciality | General Practice |
| Location | 235 Prospect Ave, Hackensack, New Jersey |
| Authorized Official Name and Position | Robin Ellen Leder (OWNER) |
| Authorized Official Contact | 2015251155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robin Ellen Leder, M.d., L.l.c. 235 Prospect Ave Suite Lb Hackensack NJ 07601-2510 Ph: (201) 525-1155 | Robin Ellen Leder, M.d., L.l.c. 235 Prospect Ave Suite Lb Hackensack NJ 07601-2510 Ph: (201) 525-1155 |
| NPI Number | 1114063872 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4587764592 |
|---|---|
| Medicare Enrollment ID | O20070705000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114063872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Robin E Leder |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1750437950 PECOS PAC ID: 4789784794 Enrollment ID: I20070705000141 |
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