Healthcare Provider Details

I. General information

NPI: 1093627705
Provider Name (Legal Business Name): STEPHANIE MARIE LEONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HOLMES RD
ROCHESTER NY
14626-3651
US

IV. Provider business mailing address

60 BUCKMAN RD
ROCHESTER NY
14615-1460
US

V. Phone/Fax

Practice location:
  • Phone: 585-966-2000
  • Fax:
Mailing address:
  • Phone: 585-966-4905
  • Fax: 585-966-4936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number517311
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: