Provider Demographics
NPI:1215515556
Name:LEAHEY, CAITLIN (NP)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:LEAHEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TOWER PL FL 8
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-3715
Mailing Address - Country:US
Mailing Address - Phone:518-489-4471
Mailing Address - Fax:518-489-4506
Practice Address - Street 1:6 CARE LN STE 101
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-8652
Practice Address - Country:US
Practice Address - Phone:518-584-4953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY67341201163W00000X
NYF34689701363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse