Individual
ELAINE LEVENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 PATERSON ST, CLINICAL ACADEMIC BUILDING - SUITE 5100A, NEW BRUNSWICK, NJ 08901-1962
(732) 235-6968
Mailing address
66 W GILBERT ST, 2ND FLOOR, TINTON FALLS, NJ 07701-4947
(732) 212-0051
(732) 212-0713
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA51493
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0395307
—
NJ
01
—
110079000
RR MCR PTAN
NJ
Enumeration date
11/14/2006
Last updated
10/28/2009
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