Provider Demographics
NPI:1831413970
Name:HILL, LEIGH ELLEN (RPH)
Entity type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:ELLEN
Last Name:HILL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 GENESEE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE KATRINE
Mailing Address - State:NY
Mailing Address - Zip Code:12449-5203
Mailing Address - Country:US
Mailing Address - Phone:845-336-6692
Mailing Address - Fax:
Practice Address - Street 1:177 BROADWAY
Practice Address - Street 2:
Practice Address - City:PORT EWEN
Practice Address - State:NY
Practice Address - Zip Code:12466
Practice Address - Country:US
Practice Address - Phone:845-331-4229
Practice Address - Fax:845-430-4593
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33942183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist