Provider Demographics
NPI:1457438426
Name:TARTAGLIA, LEAH KATHLEEN (MS, PT)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:KATHLEEN
Last Name:TARTAGLIA
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:MRS
Other - First Name:LEAH
Other - Middle Name:KATHLEEN
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, PT
Mailing Address - Street 1:362 SHORE ACRES DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-5810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 PENBROOKE DR
Practice Address - Street 2:BLDG 2, SUITE A
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-2041
Practice Address - Country:US
Practice Address - Phone:585-377-9626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022250225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist