Individual
DR. MARK ROBERT LEITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
107 OCEAN AVE, WOODMERE, NY 11598-1440
(515) 382-3470
(516) 569-7564
Mailing address
107 OCEAN AVE, WOODMERE, NY 11598-1440
(515) 382-3470
(516) 569-7564
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
NOO4255-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01039005
—
NY
Enumeration date
05/16/2007
Last updated
12/10/2007
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