Provider Demographics
NPI:1114242427
Name:KACSUR, LEANNE (DPT)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:KACSUR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 REGENT ST
Mailing Address - Street 2:SUITE 503
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1675
Mailing Address - Country:US
Mailing Address - Phone:973-422-0888
Mailing Address - Fax:
Practice Address - Street 1:5 REGENT ST
Practice Address - Street 2:SUITE 503
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1675
Practice Address - Country:US
Practice Address - Phone:973-422-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01326300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist