Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PROF. LEAH GYNELL WALLACE, PA-C
ActivePROF. LEAH GYNELL WALLACE, PA-C is a Physician Assistant healthcare provider located in MADISON, Connecticut. NPI 1518233931 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · MADISON, CT
Registration Details
- NPI Number
- 1518233931
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 29, 2012 (14.366970616101 yrs)
- Last Updated
- Feb 25, 2015
- License
-
002731 (CT)
Practice Information
- Address
-
1347 BOSTON POST RDSUITE 106MADISON, CT, 064433475Browse CT providers · Browse ZIP 06443
- Phone
- 2037795207
- Fax
- 2037795792
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in MADISON, CT
| Name | Credential | NPI |
|---|---|---|
| JAVIER MOTTA | PA | 1194807180 |
| SARAH ORLANDO | PA-C | 1316164858 |
| SUSANNE L SCOFIELD HINTON | PA-C | 1548595275 |
| JESSICA L PAULSON | PA-C | 1366799587 |
| LARISSA MAGNESS FOPEANO | PA | 1326396284 |
| BRAYDEN ORNDORFF | PA-C | 1982155347 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.