Provider Demographics
NPI:1760480354
Name:LESSER, CONCHETTA ANDREA (PHARMD, BCACP)
Entity Type:Individual
Prefix:DR
First Name:CONCHETTA
Middle Name:ANDREA
Last Name:LESSER
Suffix:
Gender:F
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20227 N 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-3242
Mailing Address - Country:US
Mailing Address - Phone:602-405-6280
Mailing Address - Fax:
Practice Address - Street 1:20227 N 27TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-3242
Practice Address - Country:US
Practice Address - Phone:623-869-5780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS013215183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist