Healthcare Provider Details

I. General information

NPI: 1497008049
Provider Name (Legal Business Name): LEAH CONTRINO P.A.-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2012
Last Update Date: 10/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST BRIGHAM AND WOMEN'S, DEPARTMENT OF GYNECOLOGIC ONCOLOGY
BOSTON MA
02115-6110
US

IV. Provider business mailing address

75 FRANCIS STREET, BRIGHAM AND WOMEN'S HOSPITAL DEPARTMENT OF GYNECOLOGIC ONCOLOGY
BOSTON MA
02115-0000
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-8843
  • Fax: 617-738-5124
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA4444
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: