Individual
DR. LEON WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 POMPTON AVE, VERONA, NJ 07044-2917
(201) 896-0900
(201) 896-2627
Mailing address
59 KOCH AVE, MORRIS PLAINS, NJ 07950-4400
(973) 538-1800
(973) 889-8799
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MB340004
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
514375
AETNA
NJ
Enumeration date
09/29/2006
Last updated
04/27/2017
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