Provider Demographics
NPI:1366582520
Name:LEIBU, RACHEL ROSENSTOCK (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ROSENSTOCK
Last Name:LEIBU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MADISON AVENUE
Mailing Address - Street 2:P. O, BOX 1956
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07962
Mailing Address - Country:US
Mailing Address - Phone:973-971-5440
Mailing Address - Fax:973-290-2928
Practice Address - Street 1:100 MADISON AVENUE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07962
Practice Address - Country:US
Practice Address - Phone:973-971-5440
Practice Address - Fax:973-290-2928
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA059988207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine