Provider Demographics
NPI:1700173978
Name:CUDDIHY, LEISHA JANE (PHD)
Entity Type:Individual
Prefix:
First Name:LEISHA
Middle Name:JANE
Last Name:CUDDIHY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LEISHA
Other - Middle Name:JANE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2337 S CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2645
Mailing Address - Country:US
Mailing Address - Phone:585-341-7575
Mailing Address - Fax:
Practice Address - Street 1:2337 S CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2645
Practice Address - Country:US
Practice Address - Phone:585-341-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014603103TC0700X
NY24813207R00000X
NY024813103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine