Healthcare Provider Details

I. General information

NPI: 1871281741
Provider Name (Legal Business Name): LIAM R LEBLANC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 S CLINTON AVE STE 310
ROCHESTER NY
14618-5717
US

IV. Provider business mailing address

191 WINTERGREEN WAY
ROCHESTER NY
14618-4832
US

V. Phone/Fax

Practice location:
  • Phone: 585-473-3535
  • Fax:
Mailing address:
  • Phone: 774-266-3451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number341826
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: