Organization Name: | LEON DICK, MD PA |
NPI Number: | 1770901845 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEON S DICK (PRESIDENT) |
Mailing Address: | 2232 Millburn Ave Maplewood |
State: | NJ US |
Postal Code: | 070402605 |
Phone Number: | 9737638087 |
Fax Number: | 9737636482 |
NPI Enumeration Date: | 04/04/2014 |
NPI Last Update Date: | 04/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 25MA03208100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |