Provider Demographics
NPI:1275230054
Name:KOHUTE, LEILA ROSE (OTR)
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:ROSE
Last Name:KOHUTE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:NEWFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08344-5575
Mailing Address - Country:US
Mailing Address - Phone:609-330-7400
Mailing Address - Fax:
Practice Address - Street 1:5429 HARDING HWY
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2263
Practice Address - Country:US
Practice Address - Phone:609-625-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00387400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist