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General NPI Number Information
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NPI Number | 1962475285
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Entity Type | Individual
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Provider Name | RICHARD S LEEDS MD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 08/03/2012
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Provider Practice Location Address
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Address Line | 225 JACKSON STREET
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-3060
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Country | US
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Telephone | 908-526-8668
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Fax | 908-231-6781
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Provider Business Mailing Address
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Address Line | 225 JACKSON STREET
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-3060
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Country | US
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Telephone | 908-526-8668
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Fax | 908-231-6781
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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 | 25MA49335
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License Number State | NJ
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