Provider Demographics
NPI:1699443218
Name:LEEDS, SYDNEY JAYE (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:JAYE
Last Name:LEEDS
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HIGHLAND AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-1507
Mailing Address - Country:US
Mailing Address - Phone:203-559-0830
Mailing Address - Fax:
Practice Address - Street 1:106 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-8203
Practice Address - Country:US
Practice Address - Phone:781-283-1129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer