Provider Demographics
NPI:1245562925
Name:LEAHY, SARAH ELIZABETH (DC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:LEAHY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 ELM ST
Mailing Address - Street 2:STE 120
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-4530
Mailing Address - Country:US
Mailing Address - Phone:781-467-0088
Mailing Address - Fax:781-467-0098
Practice Address - Street 1:166 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2098
Practice Address - Country:US
Practice Address - Phone:516-294-1100
Practice Address - Fax:516-294-2734
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011807-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor