Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 46TR00955800 | NJ |
NPI | 1740889278 |
---|---|
Provider Name | Zara Joelle Leibowitz |
First Address | Manalapan, NJ 07726-2922 |
Second Address | Manalapan, NJ 07726-2922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2020 |
Last Update Date | 26/10/2020 |