Healthcare Provider Details

I. General information

NPI: 1679635205
Provider Name (Legal Business Name): ALDEN LEIFER, MD. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 BROADWAY STE 114
PATERSON NJ
07514-1526
US

IV. Provider business mailing address

680 BROADWAY SUITE 114
PATERSON NJ
07514
US

V. Phone/Fax

Practice location:
  • Phone: 973-742-4747
  • Fax: 973-742-0629
Mailing address:
  • Phone: 973-742-4747
  • Fax: 973-742-0629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberMA46643
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: ALDEN LEIFER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 973-742-4747