MEDICARE: DR. COLIN LEADBEATER AUDIOLOGIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	002886-01	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912553017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLIN LEADBEATER AUDIOLOGIST

Provider Business Mailing Address
First Line	:	2365 S CLINTON AVE STE 200
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2663
Country	:	US
Telephone Number	:	585-758-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2365 S CLINTON AVE STE 200
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2663
Country	:	US
Telephone Number	:	585-758-5700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2019
Last Update Date	:	01/23/2026

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