Provider Demographics
NPI:1679696413
Name:ALDEN LEIFER, MD. PC
Entity type:Organization
Organization Name:ALDEN LEIFER, MD. PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEIFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-742-3132
Mailing Address - Street 1:680 BROADWAY STE 114
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-1526
Mailing Address - Country:US
Mailing Address - Phone:973-742-3132
Mailing Address - Fax:
Practice Address - Street 1:680 BROADWAY STE 114
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1526
Practice Address - Country:US
Practice Address - Phone:973-742-3132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTD2182156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0357405Medicaid
NJ0357405Medicaid