Healthcare Provider Details

I. General information

NPI: 1124580956
Provider Name (Legal Business Name): VIRGINIA ANNE LEONE MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 N MAIN ST
STRONG ME
04983-3005
US

IV. Provider business mailing address

2579 OLD QUARRY RD APT 2333
SAN DIEGO CA
92108-2787
US

V. Phone/Fax

Practice location:
  • Phone: 207-684-4010
  • Fax: 207-684-3369
Mailing address:
  • Phone: 781-724-4487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number180424
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: