=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639028152
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEIGH ANN TUCCOLO PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2026
-----------------------------------------------------
Last Update Date | 01/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19 QUENTIN DR
-----------------------------------------------------
City | LONDONDERRY
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03053-6124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-552-0054
-----------------------------------------------------
Fax | 603-552-0054
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19 QUENTIN DR
-----------------------------------------------------
City | LONDONDERRY
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03053-6124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-552-0054
-----------------------------------------------------
Fax | 603-552-0054
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PTL15524
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------