Provider Demographics
NPI:1043473416
Name:LEIBOWITZ, ROBERT E (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:LEIBOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MCCAY WAY
Mailing Address - Street 2:
Mailing Address - City:DELANCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-5226
Mailing Address - Country:US
Mailing Address - Phone:856-461-2456
Mailing Address - Fax:856-461-6061
Practice Address - Street 1:8 MCCAY WAY
Practice Address - Street 2:
Practice Address - City:DELANCO
Practice Address - State:NJ
Practice Address - Zip Code:08075-5226
Practice Address - Country:US
Practice Address - Phone:856-461-2456
Practice Address - Fax:856-461-6061
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02872300208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery