Provider Demographics
NPI:1134722176
Name:CSERNYIK, LESLIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:CSERNYIK
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 1:1183 WILLIAMS RESERVE BLVD
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-9314
Mailing Address - Country:US
Mailing Address - Phone:330-335-2610
Mailing Address - Fax:330-335-2517
Practice Address - Street 1:1183 WILLIAMS RESERVE BLVD
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-9314
Practice Address - Country:US
Practice Address - Phone:330-335-2610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-120353183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist