Active NPI
Leanne Licitra
- Occupational Therapist
- Jersey City, NJ
National Provider Identifier
1134837685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 100 Hoboken Ave
Jersey City, NJ 07310-1028 - Phone
- (973) 897-9397
- NPI assigned
- Nov 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
100 Hoboken Ave
Jersey City, NJ 07310-1028
Mailing address
26 Mandeville Ave
Pequannock, NJ 07440-1538
Phone (973) 897-9397
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1134837685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 MANDEVILLE AVE",
"city": "PEQUANNOCK",
"state": "NJ",
"postal_code": "074401538",
"telephone_number": "973-897-9397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HOBOKEN AVE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073101028",
"telephone_number": "973-897-9397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICITRA",
"first_name": "LEANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-14",
"last_updated": "2022-11-14",
"certification_date": "2022-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.