Individual
MRS. SALLY JOY LEEDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
101 2ND ST, LAKEWOOD, NJ 08701-3324
(732) 363-6655
Mailing address
101 2ND ST, LAKEWOOD, NJ 08701-3324
(732) 363-6655
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NN06598100
NJ
Other
Enumeration date
12/11/2012
Last updated
01/18/2017
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