Provider Demographics
NPI:1922114586
Name:LEFFLER, MICHELLE L (RPH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:LEFFLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10605 W SHELBY RD
Mailing Address - Street 2:APT 4
Mailing Address - City:MIDDLEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14105-9316
Mailing Address - Country:US
Mailing Address - Phone:585-205-0403
Mailing Address - Fax:585-798-9632
Practice Address - Street 1:526 MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14103-1421
Practice Address - Country:US
Practice Address - Phone:585-798-1650
Practice Address - Fax:585-798-9632
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist