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General NPI Number Information
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NPI Number | 1164256384
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Entity Type | Individual
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Provider Name | LESLIE JEAN LAUFER LMT
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Gender |
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Dates
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Enumeration Date | 08/29/2024
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 125 MADISON ST
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City | BOONTON
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State | NJ
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Zip | 07005-2153
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Country | US
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Telephone | 973-299-2430
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MOHICAN PL
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City | LAKE HIAWATHA
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State | NJ
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Zip | 07034-2812
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Country | US
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Telephone | 646-427-8586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 18KT01379600
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License Number State | NJ
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