Provider Demographics
NPI:1740370154
Name:LEIDIGH, CATHERINE DEVLIN (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:DEVLIN
Last Name:LEIDIGH
Suffix:
Gender:F
Credentials:MD
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 157
Mailing Address - Street 2:29 HOSPITAL HILL RD SUITE #1400
Mailing Address - City:SHARON
Mailing Address - State:CT
Mailing Address - Zip Code:06069-0157
Mailing Address - Country:US
Mailing Address - Phone:860-364-5523
Mailing Address - Fax:860-364-0544
Practice Address - Street 1:29 HOSPITAL HILL RD
Practice Address - Street 2:SUITE #1400
Practice Address - City:SHARON
Practice Address - State:CT
Practice Address - Zip Code:06069-0157
Practice Address - Country:US
Practice Address - Phone:860-364-5523
Practice Address - Fax:860-364-0544
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT032131208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY86F471OtherBLUE CROSS BLUE SHIELD
NY86F471OtherBLUE CROSS BLUE SHIELD