Provider Demographics
NPI:1619704624
Name:LEITER, DINAH (OTR/L)
Entity type:Individual
Prefix:
First Name:DINAH
Middle Name:
Last Name:LEITER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07014-1328
Mailing Address - Country:US
Mailing Address - Phone:973-365-1444
Mailing Address - Fax:973-365-1446
Practice Address - Street 1:340 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07014-1328
Practice Address - Country:US
Practice Address - Phone:973-365-1444
Practice Address - Fax:973-365-1446
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00248700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist