Glenn R Leslie, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MB42681 Issued in NJ

Practice address

10 Franklin Tpke
Mahwah, NJ 07430-1304

Phone

(201) 529-0033

Fax

(201) 529-5913

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bon Secours Charity Health System Medical Group, P.C.

  • Internal Medicine Physician
  • Warwick, NY
  • NPI 1487694345
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1285712950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FRANKLIN TPKE",
            "address_2": "MAHWAH MEDICAL",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "07430",
            "telephone_number": "201-529-3380",
            "fax_number": "201-529-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FRANKLIN TPKE",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074301304",
            "telephone_number": "201-529-0033",
            "fax_number": "201-529-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "GLENN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MB42681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET INS ID",
            "identifier": "0K6749",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID AS OF 01/01/12",
            "identifier": "223636986",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD INS PLAN",
            "identifier": "BP329",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "222790526",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle O Flaherty PT PC
• John Lagrimas
• Barbara J Lankelis
• Kanae Larkin, LMT
• Gloria Leder, LCSW, MSW
• Rachel Levine Sicolo, MSPT
• Jennifer Lynn Levy, M.S.P.T
• Justin Michael Liddy, PA-C
• Colette D Lieber, MD
• Victoria Lieto, OTR

• Internal Medicine Physician in Mahwah, NJ
• Providers in Mahwah, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.