Provider Demographics
NPI:1699215467
Name:LEIPLER, JESSICA FAYE
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:FAYE
Last Name:LEIPLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-2806
Mailing Address - Country:US
Mailing Address - Phone:716-359-5352
Mailing Address - Fax:
Practice Address - Street 1:95 JOHN MUIR DR
Practice Address - Street 2:SUITE 100
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-1144
Practice Address - Country:US
Practice Address - Phone:716-800-2328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009583-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant