Leonard Teitelbaum, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA1654600 Issued in NJ

Practice address

1055 Hamburg Tpke
Wayne, NJ 07470-3235

Phone

(973) 305-0064

Fax

(973) 305-0074

NPI assigned

Mar 17, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1629439773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 UTOPIA PKWY",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113574142",
            "telephone_number": "718-819-6805",
            "fax_number": "347-841-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703235",
            "telephone_number": "973-305-0064",
            "fax_number": "973-305-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEITELBAUM",
        "first_name": "LEONARD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-17",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA1654600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.