Provider Demographics
NPI:1376996942
Name:LEO, ELANA JEWEL (PHARMD)
Entity type:Individual
Prefix:
First Name:ELANA
Middle Name:JEWEL
Last Name:LEO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 BABCOCK BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5815
Mailing Address - Country:US
Mailing Address - Phone:412-748-4610
Mailing Address - Fax:412-748-4611
Practice Address - Street 1:9100 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5815
Practice Address - Country:US
Practice Address - Phone:412-748-4610
Practice Address - Fax:412-748-4611
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25974183500000X
PARP455872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist