Provider Demographics
NPI:1922182435
Name:LEYBOVICH, JENNY (OT)
Entity Type:Individual
Prefix:MS
First Name:JENNY
Middle Name:
Last Name:LEYBOVICH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WHITMAN DR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6932
Mailing Address - Country:US
Mailing Address - Phone:718-614-7140
Mailing Address - Fax:
Practice Address - Street 1:240 WHITMAN DR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6932
Practice Address - Country:US
Practice Address - Phone:718-614-7140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013992225X00000X
NY013992-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist