Provider Demographics
NPI:1477625408
Name:SIOCHI, LEONARD DALE LABIO (PT)
Entity Type:Individual
Prefix:MR
First Name:LEONARD DALE
Middle Name:LABIO
Last Name:SIOCHI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MUIRFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-5147
Mailing Address - Country:US
Mailing Address - Phone:732-521-3272
Mailing Address - Fax:
Practice Address - Street 1:1584 US HIGHWAY 130
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-3040
Practice Address - Country:US
Practice Address - Phone:732-821-7878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00797300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist