Provider Demographics
NPI:1164499943
Name:LEONE, LAURA MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MARIE
Last Name:LEONE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MATLOCK ST
Mailing Address - Street 2:
Mailing Address - City:LIDO BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-5018
Mailing Address - Country:US
Mailing Address - Phone:516-659-3178
Mailing Address - Fax:
Practice Address - Street 1:450 MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3598
Practice Address - Country:US
Practice Address - Phone:516-845-1044
Practice Address - Fax:516-293-2125
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005034627183500000X
NY052286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist