Leez-Betina Petit

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00760000 Issued in NJ

Practice address

14 Gallaway LN
Willingboro, NJ 08046-3226

Phone

(908) 494-5150

NPI assigned

Feb 20, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Functional Performance Institute PC

  • Physical Medicine & Rehabilitation Physician
  • Montville, NJ
  • NPI 1184951501

  Chiropractor

  Medicare reassignment NPD
• Origin LLC

  • Multi-Specialty Clinic/Center
  • Willingboro, NJ
  • NPI 1124691647
  NPD Authorized official

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1770049249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 GALLAWAY LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080463226",
            "telephone_number": "908-494-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 GALLAWAY LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080463226",
            "telephone_number": "908-494-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETIT",
        "first_name": "LEEZ-BETINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00149800",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00760000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karel Joseph Paul, M.D.
• Lucie Paul
• Tracy Logan Persily, D.O.
• Personalized Independent Living Opporuntities & Training Services
• Muhammad Ahsan Pervez, MD
• Donald Petroski, M.D.
• Philadelphia Eye Associates of South Jersey
• Nivia Nivia Phillips, APN
• Deborah Pierce, MECHANOTHERAPIST
• Pink Bra Boutique LLC

• Chiropractor in Willingboro, NJ
• Providers in Willingboro, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.