Provider Demographics
NPI:1326616335
Name:FINCH, LEAH (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:FINCH
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 LEXINGTON WAY N
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-9152
Mailing Address - Country:US
Mailing Address - Phone:203-306-6811
Mailing Address - Fax:
Practice Address - Street 1:233 BROAD ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3235
Practice Address - Country:US
Practice Address - Phone:860-810-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5244363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant