Provider Demographics
NPI:1427363944
Name:VAZ, LEONARD (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:VAZ
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 WYNDMOOR DR
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1259
Mailing Address - Country:US
Mailing Address - Phone:609-371-1958
Mailing Address - Fax:
Practice Address - Street 1:1089 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-3119
Practice Address - Country:US
Practice Address - Phone:609-443-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01968700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist