Provider Demographics
NPI:1336168210
Name:GALANTE, LEON J JR (PT)
Entity Type:Individual
Prefix:MR
First Name:LEON
Middle Name:J
Last Name:GALANTE
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:66 WEST GILBERT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:2315 HIGHWAY 34
Practice Address - Street 2:SUITE A
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1423
Practice Address - Country:US
Practice Address - Phone:732-451-5510
Practice Address - Fax:732-223-0116
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00924900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092688BC1Medicare UPIN
NJ092688BC1Medicare ID - Type Unspecified