Provider Demographics
NPI:1689953572
Name:BITTNER, LESLIE MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:MARIE
Last Name:BITTNER
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 1:3910 TURNBRIDGE CT
Mailing Address - Street 2:APT 228
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-3082
Mailing Address - Country:US
Mailing Address - Phone:330-460-3914
Mailing Address - Fax:
Practice Address - Street 1:10701 EAST BLVD # 119W
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH 03330944183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist