Healthcare Provider Details

I. General information

NPI: 1548592454
Provider Name (Legal Business Name): LEAH CAROLYN HUFF PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2010
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 NORTHWOOD RD
UNIVERSITY HEIGHTS OH
44118-3738
US

IV. Provider business mailing address

3750 NORTHWOOD RD
UNIVERSITY HEIGHTS OH
44118-3738
US

V. Phone/Fax

Practice location:
  • Phone: 606-316-3422
  • Fax:
Mailing address:
  • Phone: 606-316-3422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number002951
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: