Provider Demographics
NPI:1669426508
Name:LEFF, PETER D (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:D
Last Name:LEFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 LEWIS AVE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-2121
Mailing Address - Country:US
Mailing Address - Phone:203-634-0134
Mailing Address - Fax:203-630-3961
Practice Address - Street 1:455 LEWIS AVE
Practice Address - Street 2:SUITE 216
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2121
Practice Address - Country:US
Practice Address - Phone:203-634-0134
Practice Address - Fax:203-630-3961
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034825208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010034825CT01OtherBLUE CROSS/ BLUE SHIELD
CTP379134OtherOXFORD
CT1117925002OtherCIGNA
CT1348251Medicaid
CT1704267OtherUNITED HEALTHCARE
CT4653811OtherAETNA
CTOR2835OtherHEALTHNET
CT034825OtherCONNECTICARE
CT1348251Medicaid