Provider Demographics
NPI:1841586963
Name:LESIAK, ELZBIETA (PHYS THERAPIST ASSIS)
Entity Type:Individual
Prefix:MRS
First Name:ELZBIETA
Middle Name:
Last Name:LESIAK
Suffix:
Gender:F
Credentials:PHYS THERAPIST ASSIS
Other - Prefix:
Other - First Name:ELZBIETA
Other - Middle Name:
Other - Last Name:WYSOCKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 SHEPHERD LN
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2188
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 SHEPHERD LN
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2188
Practice Address - Country:US
Practice Address - Phone:973-942-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00206200225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant