NPIMap

Organization Active NPI

Lifespan Therapy & Sports Rehab LLC

  • Occupational Therapist
  • East Brunswick, NJ
National Provider Identifier
1043294523
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
LIFESPAN THERAPY & SPORTS REHAB LLC
Practice address
758 Highway 18
Ste 106
East Brunswick, NJ 08816-4910
Phone
(732) 254-0090
Fax
(732) 254-2292
NPI assigned
Nov 30, 2005
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leslie K Marcks, PTNPI 1487638995
Title
Partner
Phone
(732) 254-0090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

758 Highway 18
Ste 106
East Brunswick, NJ 08816-4910

Mailing address

PO Box 4414
Brick, NJ 08723-1614
Phone (732) 785-0040

National Provider Directory

National Provider Directory

Locations

758 State Route 18
Ste 106
East Brunswick, NJ 08816
Phone (732) 254-0090

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1043294523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4414",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087231614",
            "telephone_number": "732-785-0040",
            "fax_number": "732-785-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 HIGHWAY 18",
            "address_2": "STE 106",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164910",
            "telephone_number": "732-254-0090",
            "fax_number": "732-254-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN THERAPY & SPORTS REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MARCKS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "732-254-0090",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.