Provider Demographics
NPI:1669468534
Name:LEONARDI, RACHEL ADELIA LIM (DO)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ADELIA LIM
Last Name:LEONARDI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ADELIA
Other - Last Name:LIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4 CORPORATE DR
Mailing Address - Street 2:SUITE 484
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6211
Mailing Address - Country:US
Mailing Address - Phone:203-944-9898
Mailing Address - Fax:203-944-9899
Practice Address - Street 1:4 CORPORATE DR
Practice Address - Street 2:SUITE 484
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6211
Practice Address - Country:US
Practice Address - Phone:203-944-9898
Practice Address - Fax:203-944-9899
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045470207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology