Provider Demographics
NPI:1851783351
Name:SCISCO, LEIGH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:SCISCO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:
Other - Last Name:OYLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:98 MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2500
Mailing Address - Country:US
Mailing Address - Phone:860-620-9954
Mailing Address - Fax:
Practice Address - Street 1:98 MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2500
Practice Address - Country:US
Practice Address - Phone:860-620-9954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-21
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01474400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist