Provider Demographics
NPI:1114933140
Name:LESZUNOV, DAVID (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:LESZUNOV
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 RIDGE AVENUE
Mailing Address - Street 2:
Mailing Address - City:MCKNIGHT
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6914
Mailing Address - Country:US
Mailing Address - Phone:412-366-3104
Mailing Address - Fax:330-847-7708
Practice Address - Street 1:240 RIDGE AVENUE
Practice Address - Street 2:
Practice Address - City:MCKNIGHT
Practice Address - State:PA
Practice Address - Zip Code:15237-6914
Practice Address - Country:US
Practice Address - Phone:412-366-3104
Practice Address - Fax:330-847-7708
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030127L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist