Provider Demographics
NPI:1104790708
Name:CAROMILE, LESLIE (PHD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:CAROMILE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CONCORD CIR
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-3401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:UCONN HEALTH ROOM L-5008
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-3501
Practice Address - Country:US
Practice Address - Phone:560-990-5044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study