Provider Demographics
NPI:1255506937
Name:MONTEFORTE, LEONARD JOSEPH (RPH)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:JOSEPH
Last Name:MONTEFORTE
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 1:1 TUCKAHOE AVE
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-2924
Mailing Address - Country:US
Mailing Address - Phone:914-771-5640
Mailing Address - Fax:914-771-8494
Practice Address - Street 1:1 TUCKAHOE AVE
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-2924
Practice Address - Country:US
Practice Address - Phone:914-771-5640
Practice Address - Fax:914-771-8494
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038126183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist