Provider Demographics
NPI:1811591761
Name:KALSCH, LEANNE
Entity Type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:
Last Name:KALSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 LALLY LN
Mailing Address - Street 2:
Mailing Address - City:WEST CREEK
Mailing Address - State:NJ
Mailing Address - Zip Code:08092-9675
Mailing Address - Country:US
Mailing Address - Phone:609-276-3040
Mailing Address - Fax:
Practice Address - Street 1:1 S NEW YORK RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9610
Practice Address - Country:US
Practice Address - Phone:609-748-0717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-22
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02254000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist