Healthcare Provider Details

I. General information

NPI: 1790757870
Provider Name (Legal Business Name): JEFFREY LEFKOWITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11-26 SADDLE RIVER RD
FAIR LAWN NJ
07410-5634
US

IV. Provider business mailing address

11-26 SADDLE RIVER RD
FAIR LAWN NJ
07410-5634
US

V. Phone/Fax

Practice location:
  • Phone: 201-796-9200
  • Fax: 201-796-7606
Mailing address:
  • Phone: 201-796-9200
  • Fax: 201-796-7606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMA049671
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: