Leidys Casey

Key facts

NPI

1245070465

Entity type

Individual (NPI type 1)

Primary specialty

Massage Therapist 225700000X

License

18KT00378900 (NJ)

Practice address

473 River Rd Ste 139
Edgewater, NJ 07020-1145

Phone

(201) 500-3826

NPI assigned

May 27, 2024

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 27, 2024.

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1245070465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 RIVER RD STE 139",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201145",
            "telephone_number": "201-500-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 RIVER RD STE 139",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201145",
            "telephone_number": "201-500-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "LEIDYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NJ",
            "license": "18KT00378900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Edgewater, NJ · Massage Therapist in New Jersey