Provider Demographics
NPI:1972779346
Name:LEAHY, CASSANDRA P (RN, MSN, LCCE, IBCLC)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:P
Last Name:LEAHY
Suffix:
Gender:F
Credentials:RN, MSN, LCCE, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 TULIP LN
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1148
Mailing Address - Country:US
Mailing Address - Phone:732-526-7078
Mailing Address - Fax:
Practice Address - Street 1:73 TULIP LN
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1148
Practice Address - Country:US
Practice Address - Phone:732-526-7078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO11337200163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant