Provider Demographics
NPI:1609580851
Name:LEACH, HENRY FRANCIS
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:FRANCIS
Last Name:LEACH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1691 US HIGHWAY 9 # CN2025
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1245
Mailing Address - Country:US
Mailing Address - Phone:732-914-3826
Mailing Address - Fax:732-341-3674
Practice Address - Street 1:1691 US HIGHWAY 9 # CN2025
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1245
Practice Address - Country:US
Practice Address - Phone:732-914-3826
Practice Address - Fax:732-341-3674
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI035307001835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric