Provider Demographics
NPI:1407004955
Name:MILLETTE, LEO ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:ALBERT
Last Name:MILLETTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 OLD BRANCHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-6013
Mailing Address - Country:US
Mailing Address - Phone:203-438-3483
Mailing Address - Fax:860-665-3644
Practice Address - Street 1:185 OLD BRANCHVILLE RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-6013
Practice Address - Country:US
Practice Address - Phone:203-438-3483
Practice Address - Fax:860-665-3644
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0279662083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine