Provider Demographics
NPI:1093099798
Name:LEONARD, MONICA BEATRIZ (RPH)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:BEATRIZ
Last Name:LEONARD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 CATHY RD
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-2043
Mailing Address - Country:US
Mailing Address - Phone:978-256-7660
Mailing Address - Fax:
Practice Address - Street 1:277 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-2321
Practice Address - Country:US
Practice Address - Phone:978-657-9401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH26948183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist