Provider Demographics
NPI:1942583042
Name:GUZZARDO, LEAH V (PT, DPT, PCS)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:V
Last Name:GUZZARDO
Suffix:
Gender:F
Credentials:PT, DPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 NATHAN DR
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-1559
Mailing Address - Country:US
Mailing Address - Phone:610-639-6059
Mailing Address - Fax:
Practice Address - Street 1:1623 NATHAN DR
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-1559
Practice Address - Country:US
Practice Address - Phone:610-639-6059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-25
Last Update Date:2011-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA013147002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics