Provider Demographics
NPI:1578594867
Name:LEIGH ANN HUTCHINSON, M.D., P.C.
Entity Type:Organization
Organization Name:LEIGH ANN HUTCHINSON, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-224-1819
Mailing Address - Street 1:107 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-2320
Mailing Address - Country:US
Mailing Address - Phone:631-224-1819
Mailing Address - Fax:631-224-1812
Practice Address - Street 1:107 W MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-2320
Practice Address - Country:US
Practice Address - Phone:631-224-1819
Practice Address - Fax:631-224-1812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180709174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01638444Medicaid
NY01638444Medicaid
NYI48159Medicare UPIN
NYWEM341Medicare ID - Type UnspecifiedDR. LEIGH ANN HUTCHINSON