Leiter, Mark Robert

Leiter, Mark Robert is an sole proprietor health care provider with primary practice located at 107 Ocean Ave , Woodmere NY 11598-1440. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Leiter, Mark Robert can be contacted via phone (515) 382-3470.

Contact Information

Primary practice address
107 Ocean Ave Woodmere NY 11598-1440
Phone: (515) 382-3470
Fax: (516) 569-7564
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X NOO4255-1 New York

Profile Details

NPI number 1174730592
LBN Legal business name Leiter, Mark Robert
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 16th, 2007
Last updated Dec 10th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174730592 NPPES
New York MEDICAID 01039005

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