Active NPI
Kelly Anne Lease, PT
- Physical Therapist
- Union, NJ
National Provider Identifier
1689813362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00933400
- Practice address
- 700 Rahway Ave
Union, NJ 07083-6634 - Phone
- (908) 688-1991
- Fax
- (908) 688-0962
- NPI assigned
- Feb 19, 2009
- Last updated
- Feb 19, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA00933400 | NJ | Primary |
Addresses
Primary practice location
700 Rahway Ave
Union, NJ 07083-6634
Mailing address
4175 Veterans Memorial Hwy
Suite 202
Ronkonkoma, NY 11779-7639
Phone (631) 580-5200
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": "1235001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235001600000",
"number": "1689813362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4175 VETERANS MEMORIAL HWY",
"address_2": "SUITE 202",
"city": "RONKONKOMA",
"state": "NY",
"postal_code": "117797639",
"telephone_number": "631-580-5200",
"fax_number": "631-580-5222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 RAHWAY AVE",
"city": "UNION",
"state": "NJ",
"postal_code": "070836634",
"telephone_number": "908-688-1991",
"fax_number": "908-688-0962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEASE",
"first_name": "KELLY",
"middle_name": "ANNE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-19",
"last_updated": "2009-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00933400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Union, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.