Individual
LEONARDO VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
536 RIDGE RD, CEDAR GROVE, NJ 07009-1611
(973) 239-9300
Mailing address
66 W BRADFORD AVE, CEDAR GROVE, NJ 07009-1804
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTAQBO1470
NJ
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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