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General NPI Number Information
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NPI Number | 1336812593
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Entity Type | Individual
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Provider Name | SAMANTHA GAY LEAHY APRN
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Gender | Female
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Dates
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Enumeration Date | 07/26/2021
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 150 LOWER WESTFIELD ROAD
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City | HOLYOKE
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State | MA
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Zip | 01040
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Country | US
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Telephone | 413-536-2393
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Fax |
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Provider Business Mailing Address
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Address Line | 29 AVERY RD
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City | SOMERS
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State | CT
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Zip | 06071-1539
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 9805
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | RN2337692
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License Number State | MA
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