Provider Demographics
NPI:1407964711
Name:HINCHLIFFE, LEAH
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:HINCHLIFFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 BURGUNDY DR
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06037-1835
Mailing Address - Country:US
Mailing Address - Phone:860-828-1213
Mailing Address - Fax:
Practice Address - Street 1:1231 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06037-2301
Practice Address - Country:US
Practice Address - Phone:860-829-5511
Practice Address - Fax:860-829-5577
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT007599OtherLICENSE #