Leslie N Madrak, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MB06834200 Issued in NJ

Practice address

900 Route 168
Blackwood, NJ 08012-3233

Phone

(856) 857-6920

Fax

(856) 429-3826

NPI assigned

Feb 7, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Camden County Health Services Center

  • Psychiatric Hospital
  • Blackwood, NJ
  • NPI 1578559340
  NPD (past)
• Kennedy Medical Group Practice, P.C.

  • Family Medicine Physician
  • Voorhees, NJ
  • NPI 1952726796
  NPD (past)
• TMS Centers of Southern New Jersey

  • Psychiatry Physician
  • Mount Laurel, NJ
  • NPI 1255674503
  NPD (past)
• Victory Bay Recovery Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Laurel Springs, NJ
  • NPI 1700328283
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1851363485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROUTE 168",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080123233",
            "telephone_number": "856-857-6920",
            "fax_number": "856-429-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROUTE 168",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080123233",
            "telephone_number": "856-857-6920",
            "fax_number": "856-429-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRAK",
        "first_name": "LESLIE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MB06834200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8526109",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Leone
• Sarah Libros, M.S.ED, LAC
• Life Forward Home Health Care LLC
• Lifelyft
• Limitless Therapy LLC
• Maryam Mady
• Main Line Medical Supplies Inc
• Lynn Y Mann, DO
• Noelle Maples, ASSISTANT DIRECTOR
• Ashley M Markley

• Psychiatry Physician in Blackwood, NJ
• Providers in Blackwood, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.