Individual
KATHLEEN H. LEISTIKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
563 WESTFIELD AVE, WESTFIELD, NJ 07090-3300
(908) 232-5858
(908) 232-0439
Mailing address
563 WESTFIELD AVE, WESTFIELD, NJ 07090-3300
(908) 232-5858
(908) 232-0439
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA05687600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3286002
—
NJ
Enumeration date
12/18/2006
Last updated
07/08/2019
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