Individual
LESLIE FONTANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
12-15 SADDLE RIVER RD, FAIR LAWN, NJ 07410-5808
(201) 797-9522
Mailing address
12-15 SADDLE RIVER ROAD, FAIR LAWN, NJ 07410
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00299400
NJ
Other
Enumeration date
11/20/2014
Last updated
11/20/2014
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