Provider Demographics
NPI:1679863708
Name:LEO-MENSAH, FIONA A (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:FIONA
Middle Name:A
Last Name:LEO-MENSAH
Suffix:
Gender:F
Credentials:PHARMD, 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 CELEBRATION WAY
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-1821
Mailing Address - Country:US
Mailing Address - Phone:401-349-2005
Mailing Address - Fax:401-521-8923
Practice Address - Street 1:200 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4453
Practice Address - Country:US
Practice Address - Phone:401-521-4941
Practice Address - Fax:401-521-8923
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH04350183500000X
MAPH25721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist