Individual
SHIFRA K LEISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, OTR
Contact information
Practice address
65 BERGEN ST, NEWARK, NJ 07107-3001
(973) 972-0186
(973) 972-2645
Mailing address
85 REID AVE, PASSAIC, NJ 07055-3415
(973) 773-4533
(973) 365-1066
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
46TR00158500
NJ
Other
Enumeration date
10/16/2009
Last updated
10/16/2009
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