Provider Demographics
NPI:1780021428
Name:LEIDLEIN, CYNTHIA ANN
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:LEIDLEIN
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 1:4501 COUNTY ROAD 37
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14487-9400
Mailing Address - Country:US
Mailing Address - Phone:585-943-3653
Mailing Address - Fax:
Practice Address - Street 1:4501 COUNTY ROAD 37
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:NY
Practice Address - Zip Code:14487-9400
Practice Address - Country:US
Practice Address - Phone:585-943-3653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider