Provider Demographics
NPI:1255368171
Name:LEITTEN, ANN M (OTRC)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:LEITTEN
Suffix:
Gender:F
Credentials:OTRC
Other - Prefix:
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Mailing Address - Street 1:2128 ELMWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-1910
Mailing Address - Country:US
Mailing Address - Phone:716-874-4500
Mailing Address - Fax:716-874-8145
Practice Address - Street 1:2128 ELMWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-1910
Practice Address - Country:US
Practice Address - Phone:716-874-4500
Practice Address - Fax:716-874-8145
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
040511000063OtherFIDELIS FAMILY HEALTH PLU
000670011001OtherCHP FHP 201
000733832001OtherCOMMUNITY CARE
1600573OtherGROUP HEALTH INS PPO CBP
000670011001OtherBC BS WNY
NY01465154Medicaid
040511000063OtherFIDELIS CHILD HEALTH PLUS
040511000063OtherNORTH AMERICAN PREFERRED
00011249902OtherASO
040511000063OtherFIDELIS MEDICAID
0000670011001OtherCOMMUNITY BLUE STD HMO
000670011001OtherCB ADVANTAGE HMO
000670011001OtherTRADITIONAL SECURE BLUE
7400120OtherAETNA
00011249902OtherUNIVERA HEALTHCARE TRAD
00011249902OtherUNIVERA COMMERCIAL
000670011001OtherCB LABOR HEALTH HMO
040511000063OtherFIDELIS FAMILY HEALTH PLU