Healthcare Provider Details

I. General information

NPI: 1023310315
Provider Name (Legal Business Name): CHERI R LEAHY R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHERI R EDELSTEIN R.D.

II. Dates (important events)

Enumeration Date: 11/19/2010
Last Update Date: 01/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 E LAUREL RD UDP #2500
STRATFORD NJ
08084-1354
US

IV. Provider business mailing address

2201 CHAPEL AVE W # WES SUITE 100
CHERRY HILL NJ
08002-2048
US

V. Phone/Fax

Practice location:
  • Phone: 856-566-2700
  • Fax: 856-566-6873
Mailing address:
  • Phone: 856-665-2017
  • Fax: 856-488-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: