NPIMap

Stephen J Leitner, M.D.

Individual provider Active NPI Emergency Medicine Physician · Mount Holly, NJ

NPI 1669411237 · NPPES record last updated Jul 19, 2016

Key facts

NPI
1669411237
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Medicine Physician 207P00000X
License
25MA05606600 (NJ)
Practice address
175 Madison Ave
Mount Holly, NJ 08060-2038
Phone
(609) 261-7046
Fax
(609) 914-6067
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
South Jersey Emergency Physicians, PA Emergency Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA05606600 NJ Yes

Addresses

Primary practice location

175 Madison Ave
Mount Holly, NJ 08060-2038

Mailing address

10 Mulberry CT
Tabernacle, NJ 08088-9233
Phone (609) 859-0996

Other identifiers

IdentifierTypeStateIssuer
5125707MedicaidNJ

Other providers in Mount Holly, NJ

All providers in Mount Holly, NJ · Emergency Medicine Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.