Provider Demographics
NPI:1801963095
Name:LEIBOWITZ, JOSEPH M (MS,PT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:M
Last Name:LEIBOWITZ
Suffix:
Gender:M
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 WALTON ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-5016
Mailing Address - Country:US
Mailing Address - Phone:201-394-8179
Mailing Address - Fax:
Practice Address - Street 1:215 WALTON ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-5016
Practice Address - Country:US
Practice Address - Phone:201-394-8179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019720-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist