Provider Demographics
NPI:1396193561
Name:HAGHIGHAT, LEILA (MD)
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:
Last Name:HAGHIGHAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 YORK ST
Mailing Address - Street 2:YNHH DEPT OF MEDICINE, LMP 1092
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3221
Mailing Address - Country:US
Mailing Address - Phone:203-688-9503
Mailing Address - Fax:203-688-5555
Practice Address - Street 1:15 YORK ST
Practice Address - Street 2:YNHH DEPT OF MEDICINE, LMP 1092
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3221
Practice Address - Country:US
Practice Address - Phone:203-688-9503
Practice Address - Fax:203-688-5599
Is Sole Proprietor?:No
Enumeration Date:2016-05-29
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT63580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty