Healthcare Provider Details

I. General information

NPI: 1942563119
Provider Name (Legal Business Name): ANNE BURNS LEITTEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 05/15/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SULLYS TRL BLDG 20
PITTSFORD NY
14534-4552
US

IV. Provider business mailing address

101 SULLYS TRL BLDG 20
PITTSFORD NY
14534-4552
US

V. Phone/Fax

Practice location:
  • Phone: 585-544-7979
  • Fax: 585-544-7901
Mailing address:
  • Phone: 585-544-7979
  • Fax: 585-544-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number305685
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF305685
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number601931
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: