Individual
IVAN A ENRIQUEZ LEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
C-O 350 ENGLE STREET, ENGLEWOOD, NJ 07631
(201) 894-3664
Mailing address
276 ENGLE ST, APT. #15B, ENGLEWOOD, NJ 07631-2441
(201) 894-3664
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
230780
MA
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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