Healthcare Provider Details

I. General information

NPI: 1861574220
Provider Name (Legal Business Name): ROSEMARIE A LEUZZI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CENTENNIAL BLVD BUILDING 2 SUITE 201
VOORHEES NJ
08043-4689
US

IV. Provider business mailing address

900 CENTENNIAL BLVD BUILDING 2 SUITE 201
VOORHEES NJ
08043-4689
US

V. Phone/Fax

Practice location:
  • Phone: 856-325-6770
  • Fax: 856-673-4300
Mailing address:
  • Phone: 856-325-6770
  • Fax: 856-673-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA076330
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: