Provider Demographics
NPI:1720208879
Name:LEONARDO, JULIE P (NP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:P
Last Name:LEONARDO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 COBBLESTONE XING
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-1340
Mailing Address - Country:US
Mailing Address - Phone:585-385-6083
Mailing Address - Fax:585-475-7788
Practice Address - Street 1:117 LOMB MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-5608
Practice Address - Country:US
Practice Address - Phone:585-475-2255
Practice Address - Fax:585-475-7788
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330018363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily