Healthcare Provider Details

I. General information

NPI: 1417234451
Provider Name (Legal Business Name): LEFFERT CHIROPRACTIC CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2011
Last Update Date: 11/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 FOXON RD
EAST HAVEN CT
06513-1834
US

IV. Provider business mailing address

847 FOXON RD
EAST HAVEN CT
06513-1834
US

V. Phone/Fax

Practice location:
  • Phone: 203-466-1769
  • Fax: 203-467-2265
Mailing address:
  • Phone: 203-466-1769
  • Fax: 203-467-2265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number000467
License Number StateCT

VIII. Authorized Official

Name: TIMOTHY J LEFFERT
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 203-466-1769