Healthcare Provider Details

I. General information

NPI: 1821063355
Provider Name (Legal Business Name): CAROL LEICHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-9487
  • Fax: 860-545-9484
Mailing address:
  • Phone: 860-545-9487
  • Fax: 860-545-9484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number023232
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: