Provider Demographics
NPI:1275147456
Name:TSA SERVICES LLC
Entity Type:Organization
Organization Name:TSA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR/L
Authorized Official - Prefix:MRS
Authorized Official - First Name:AVIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEISER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:732-232-8043
Mailing Address - Street 1:403 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2755
Mailing Address - Country:US
Mailing Address - Phone:732-232-8043
Mailing Address - Fax:
Practice Address - Street 1:403 7TH ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2755
Practice Address - Country:US
Practice Address - Phone:732-232-8043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty