Provider Demographics
NPI:1518282730
Name:COSLER, LEON EDWARD (RPH, PHD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:EDWARD
Last Name:COSLER
Suffix:
Gender:M
Credentials:RPH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 RUSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GLENMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12077-3234
Mailing Address - Country:US
Mailing Address - Phone:518-475-1095
Mailing Address - Fax:
Practice Address - Street 1:519 HOOPER RD
Practice Address - Street 2:MEDICINE SHOPPE # 1513
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-1908
Practice Address - Country:US
Practice Address - Phone:607-748-7373
Practice Address - Fax:607-785-0849
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034684183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist