Provider Demographics
NPI:1831481662
Name:JOSEPH LEONE MD LLC
Entity type:Organization
Organization Name:JOSEPH LEONE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SICCONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-467-9744
Mailing Address - Street 1:1500 PLEASANT VALLEY WAY
Mailing Address - Street 2:SUITE 307
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2956
Mailing Address - Country:US
Mailing Address - Phone:844-467-9744
Mailing Address - Fax:973-324-0449
Practice Address - Street 1:1500 PLEASANT VALLEY WAY
Practice Address - Street 2:SUITE 307
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2956
Practice Address - Country:US
Practice Address - Phone:844-467-9744
Practice Address - Fax:973-324-0449
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSEPH LEONE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-12
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ102471QK3Medicare PIN