| NPI | 1881924058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB LEITMAN Member 732-364-3772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 40QA00645500) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NY 46TR00269300) |
| 235Z00000X Speech-Language Pathologist, (Licence: NJ 414S00507600) | |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2014-02-27 |