Provider Demographics
NPI:1952839490
Name:LEYDON, ANNIKA KATHERINE
Entity Type:Individual
Prefix:
First Name:ANNIKA
Middle Name:KATHERINE
Last Name:LEYDON
Suffix:
Gender:F
Credentials:
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 639
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-0639
Mailing Address - Country:US
Mailing Address - Phone:508-685-9506
Mailing Address - Fax:
Practice Address - Street 1:179 HIGH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-2604
Practice Address - Country:US
Practice Address - Phone:508-685-9506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program