Provider Demographics
NPI:1710521265
Name:SCHULTZ, LEAH (AGPCNP)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 SAWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4653
Mailing Address - Country:US
Mailing Address - Phone:855-242-1300
Mailing Address - Fax:
Practice Address - Street 1:180 SAWGRASS DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4653
Practice Address - Country:US
Practice Address - Phone:585-242-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309467363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health