Provider Demographics
NPI:1982862371
Name:DELANEY, LEO JOHN (RPH)
Entity Type:Individual
Prefix:
First Name:LEO
Middle Name:JOHN
Last Name:DELANEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4960 TRANSIT RD
Mailing Address - Street 2:ATTN: PHARMACY MANAGER
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4616
Mailing Address - Country:US
Mailing Address - Phone:715-685-7310
Mailing Address - Fax:716-685-7325
Practice Address - Street 1:4960 TRANSIT RD
Practice Address - Street 2:ATTN: PHARMACY MANAGER
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4616
Practice Address - Country:US
Practice Address - Phone:715-685-7310
Practice Address - Fax:716-685-7325
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32970183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY32970OtherPHARMACIST LICENSE