Provider Demographics
NPI:1073207627
Name:KAPOOR, LEENA PRIYAKANT
Entity Type:Individual
Prefix:
First Name:LEENA
Middle Name:PRIYAKANT
Last Name:KAPOOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812 SUMMER BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-7641
Mailing Address - Country:US
Mailing Address - Phone:606-224-1466
Mailing Address - Fax:
Practice Address - Street 1:2812 SUMMER BRANCH LN
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-7641
Practice Address - Country:US
Practice Address - Phone:606-224-1466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist