MEDICARE: LEORAH LALEZARI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	030905	NY

General Provider Information

NPI Number	:	1114859113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEORAH LALEZARI

Provider Business Mailing Address
First Line	:	827 S HOLT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1806
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1887 BATHGATE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-6283
Country	:	US
Telephone Number	:	718-466-3580
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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