Provider Demographics
NPI:1497756209
Name:LEU, ROBERT CHRISTIAN (MS, PT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHRISTIAN
Last Name:LEU
Suffix:
Gender:M
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-0356
Mailing Address - Country:US
Mailing Address - Phone:201-379-3464
Mailing Address - Fax:201-379-3470
Practice Address - Street 1:214 STATE ST STE 105
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5521
Practice Address - Country:US
Practice Address - Phone:201-379-3464
Practice Address - Fax:201-379-3470
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01120800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ11372458OtherCAQH NUMBER
NJ086986Medicare ID - Type Unspecified