Provider Demographics
NPI:1528878063
Name:LEITER, SORA TALYA (OT)
Entity type:Individual
Prefix:
First Name:SORA
Middle Name:TALYA
Last Name:LEITER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 ALLWOOD PL
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1252
Mailing Address - Country:US
Mailing Address - Phone:973-931-0719
Mailing Address - Fax:
Practice Address - Street 1:132 ALLWOOD PL
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1252
Practice Address - Country:US
Practice Address - Phone:973-931-0719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029286225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist