Provider Demographics
NPI:1275610420
Name:HOUGHTON, LEIGH M (NP)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:M
Last Name:HOUGHTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 S CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2608
Mailing Address - Country:US
Mailing Address - Phone:585-473-2846
Mailing Address - Fax:585-473-3098
Practice Address - Street 1:1820 S CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2608
Practice Address - Country:US
Practice Address - Phone:585-473-2846
Practice Address - Fax:585-473-3098
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ45747Medicare UPIN
NYRB4330Medicare PIN