Provider Demographics
NPI:1598183311
Name:LEEKOFF, MARK (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:LEEKOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 ROUTE 22 STE 155
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2939
Mailing Address - Country:US
Mailing Address - Phone:908-461-3433
Mailing Address - Fax:
Practice Address - Street 1:1125 ROUTE 22 STE 155
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2939
Practice Address - Country:US
Practice Address - Phone:908-947-9863
Practice Address - Fax:732-560-3206
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA109584002084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology