Provider Demographics
NPI:1568497204
Name:HUTCHINSON, LEIGH ANN (MD)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:ANN
Last Name:HUTCHINSON
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:PO BOX 5126
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-0126
Mailing Address - Country:US
Mailing Address - Phone:631-224-1819
Mailing Address - Fax:631-224-1812
Practice Address - Street 1:515 ROUTE 111
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4339
Practice Address - Country:US
Practice Address - Phone:631-224-1819
Practice Address - Fax:631-224-1812
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180709174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01638444Medicaid
NYG22849Medicare UPIN
NY01638444Medicaid