Basic Information
| Provider Information | |||||||||
| NPI: | 1609989045 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEISNER | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | RANDOLPH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 650 TOWN BANK RD | ||||||||
| Address2: | |||||||||
| City: | N CAPE MAY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082044409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098987447 | ||||||||
| FaxNumber: | 6098981912 | ||||||||
| Practice Location | |||||||||
| Address1: | 650 TOWN BANK RD | ||||||||
| Address2: | |||||||||
| City: | N CAPE MAY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082044409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098987447 | ||||||||
| FaxNumber: | 6098981912 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2006 | ||||||||
| LastUpdateDate: | 03/19/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MA042301 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.