Provider Demographics
NPI:1215454319
Name:LIENESCH, SARAH JANE (PT, DPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:LIENESCH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:866-518-0283
Mailing Address - Fax:
Practice Address - Street 1:656 SHREWSBURY AVE STE 103
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4964
Practice Address - Country:US
Practice Address - Phone:732-842-4198
Practice Address - Fax:732-842-4112
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02003700225100000X
225100000X
GAPT013011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist