Provider Demographics
NPI:1417568148
Name:GASPAR, LESLIE ANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ANNE
Last Name:GASPAR
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 1:4508 ARSENAL ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63116-2012
Mailing Address - Country:US
Mailing Address - Phone:541-678-8807
Mailing Address - Fax:
Practice Address - Street 1:5890 N BELT W
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-4618
Practice Address - Country:US
Practice Address - Phone:618-277-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019034254183500000X
IL051302514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist