Provider Demographics
NPI:1275508509
Name:GERENSKI, LEAH (DPT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:GERENSKI
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 1:3 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:LE ROY
Mailing Address - State:NY
Mailing Address - Zip Code:14482-1381
Mailing Address - Country:US
Mailing Address - Phone:585-347-0202
Mailing Address - Fax:
Practice Address - Street 1:349 W COMMERCIAL ST
Practice Address - Street 2:SUITE 1275
Practice Address - City:E ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14445-2407
Practice Address - Country:US
Practice Address - Phone:585-264-0370
Practice Address - Fax:585-264-0432
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026328225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY154654FTOtherPREFERRED CARE
NYP010026328OtherBLUECROSS BLUESHIELD
7355746OtherAETNA
NY154654FTOtherPREFERRED CARE