Provider Demographics
NPI:1942563119
Name:LEITTEN, ANNE BURNS (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:BURNS
Last Name:LEITTEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 SULLYS TRL
Mailing Address - Street 2:BLDG 20
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4552
Mailing Address - Country:US
Mailing Address - Phone:585-544-7979
Mailing Address - Fax:585-544-7901
Practice Address - Street 1:101 SULLYS TRL
Practice Address - Street 2:BLDG 20
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4552
Practice Address - Country:US
Practice Address - Phone:585-544-7979
Practice Address - Fax:585-544-7901
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY601931163W00000X
NY305685363LA2200X
NYF305685363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03947844Medicaid
NYJ400205083Medicare PIN