Provider Demographics
NPI:1336683309
Name:SASTRE, LEIGH-ANNE (CNM, RNC, CCE)
Entity Type:Individual
Prefix:MS
First Name:LEIGH-ANNE
Middle Name:
Last Name:SASTRE
Suffix:
Gender:F
Credentials:CNM, RNC, CCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 TAMARACK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-5560
Mailing Address - Country:US
Mailing Address - Phone:860-646-1157
Mailing Address - Fax:
Practice Address - Street 1:2600 TAMARACK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-5560
Practice Address - Country:US
Practice Address - Phone:860-646-1157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-11
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT01.061773163WX0003X
CT414367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient