Provider Demographics
NPI:1902948524
Name:ERSHOW, LEONARD SCOTT (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:SCOTT
Last Name:ERSHOW
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1531
Mailing Address - Country:US
Mailing Address - Phone:609-921-7071
Mailing Address - Fax:609-921-7739
Practice Address - Street 1:915 COMMONS WAY
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1531
Practice Address - Country:US
Practice Address - Phone:609-921-7071
Practice Address - Fax:609-921-7739
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC 04078111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ724185Medicare ID - Type Unspecified