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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Glenn R Leslie · Glenn R. Leslie · LESLIE GLENN R · LESLIE, GLENN R. | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| First name | Glenn | [sources] | |||
| ID Number | 00173072 | [sources] | |||
| Last name | Leslie | [sources] | |||
| Middle name | R · R. | [sources] | |||
| NPI | 1285712950 | [sources] | |||
| Sector | DO · Physician | [sources] | |||
| Title | DO | [sources] | |||
| Address | (NJ), (NJ) · 10 FRANKLIN TURNPIKE, MAHWAH, NJ 07430 · 245 WOODLAND AVENUE, RAMSEY, NJ 07446 · FMC - LEXINGTON, PO BOX, LEXINGTON, KY 40512 · Out of State, Out of State | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers disqualified from participating in New Jersey State's Medicaid program.
United States of America · OIFP
Medical providers who are precluded from participation in the Medical Assistance Program
United States of America · DHS
Medical providers deemed ineligible to participate in New York State's Medicaid program.
United States of America · OMIG
us-medny-0cbb4902063208e1ed9d433889826194f5989711 · NK-HDe52rS8rp3aivVzCX9ZuH · us-medpa-82d15250e3cf2f0d75d641b08bef664995d8ca7c · us-mednj-bc845d4267e45b4c31d8120cf18d67fbe6d89487 · us-medpa-cfa891c99fcedd309bab5c0ac9332ff1945b3e3f · us-mednj-7ea7d7954f786d678beb93823dab172adaae7730 · us-mednj-74358c8d6e1936d10f4e217e6f508521b7ceb664For experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States of America | Department of Human Services | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| 245 WOODLAND AVENUE, RAMSEY, NJ 07446 | United States of America | |
| United States of America | New Jersey Office of the State Comptroller | - |
| United States of America | New Jersey Office of the State Comptroller | - | - |
| United States of America | New York State Office of the Medicaid Inspector General | - | - |
| United States of America | New Jersey Office of the State Comptroller | - | - |
| United States of America | Department of Human Services | - | - |
| (NJ), (NJ) · NJ, NJ | United States of America |
| Out of State, Out of State | United States of America |
| 10 FRANKLIN TURNPIKE, MAHWAH, NJ 07430 | United States of America |
| FMC - LEXINGTON, PO BOX, LEXINGTON, KY 40512 | United States of America |