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General NPI Number Information
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NPI Number | 1407935398
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Entity Type | Individual
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Provider Name | LEO MARCOFF MD
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Gender | Male
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 100 MADISON AVE GAGNON C
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6136
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Country | US
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Telephone | 973-971-7416
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Fax | 973-401-2470
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Provider Business Mailing Address
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Address Line | PO BOX 416457
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City | BOSTON
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State | MA
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Zip | 02241-6457
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Country | US
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Telephone | 973-656-6280
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Fax | 973-290-7495
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | C1-0008263
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 256242
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MA09316200
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License Number State | NJ
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