Provider Demographics
NPI:1982286597
Name:LEAVY, SARAH JEANNE (MSOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEANNE
Last Name:LEAVY
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 TOWNSEND RD
Mailing Address - Street 2:
Mailing Address - City:WANAQUE
Mailing Address - State:NJ
Mailing Address - Zip Code:07465-2403
Mailing Address - Country:US
Mailing Address - Phone:973-513-2321
Mailing Address - Fax:
Practice Address - Street 1:7 NEWARK POMPTON TPKE
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:NJ
Practice Address - Zip Code:07457-1142
Practice Address - Country:US
Practice Address - Phone:973-831-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025459225X00000X
NJ46TR00981500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist