Provider Demographics
NPI:1487781589
Name:LEFF, JEROME B (DPM)
Entity type:Individual
Prefix:DR
First Name:JEROME
Middle Name:B
Last Name:LEFF
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 NETHERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4808
Mailing Address - Country:US
Mailing Address - Phone:646-483-9723
Mailing Address - Fax:212-812-3258
Practice Address - Street 1:2665 NETHERLAND AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4808
Practice Address - Country:US
Practice Address - Phone:646-483-9723
Practice Address - Fax:212-812-3258
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNOO3415213ES0131X
NYN003415213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100124779Medicare PIN
NYT84735Medicare UPIN