Healthcare Provider Details

I. General information

NPI: 1497875587
Provider Name (Legal Business Name): DR. LEANNE S KONTUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 FORT HILL AVE
CANANDAIGUA NY
14424-1159
US

IV. Provider business mailing address

400 FORT HILL AVE
CANANDAIGUA NY
14424-1159
US

V. Phone/Fax

Practice location:
  • Phone: 800-585-9772
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number050796
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP440109
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number2297
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: