Provider Demographics
NPI:1619089265
Name:LEAHY, EILEEN (NP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:LEAHY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 ALTAMONT PL
Mailing Address - Street 2:UNIT 3 / 3RD FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3063
Mailing Address - Country:US
Mailing Address - Phone:301-843-1600
Mailing Address - Fax:301-645-4734
Practice Address - Street 1:4225 ALTAMONT PL
Practice Address - Street 2:UNIT 3 / 3RD FLOOR
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3063
Practice Address - Country:US
Practice Address - Phone:301-843-1600
Practice Address - Fax:301-645-4734
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist