Provider Demographics
NPI:1124538319
Name:WEISER, LEEBA LEAH (OTR/L)
Entity Type:Individual
Prefix:
First Name:LEEBA
Middle Name:LEAH
Last Name:WEISER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7719 141ST ST APT A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3290
Mailing Address - Country:US
Mailing Address - Phone:516-724-7773
Mailing Address - Fax:
Practice Address - Street 1:3769 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2041
Practice Address - Country:US
Practice Address - Phone:718-769-9888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist