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General NPI Number Information
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NPI Number | 1104732460
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Entity Type | Individual
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Provider Name | LEISA PHILLIPS CLEVELAND PHARMACIST (RPH)
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Gender | Female
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 90 MAIN ST
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City | WINDSOR LOCKS
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State | CT
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Zip | 06096-1913
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Country | US
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Telephone | 860-623-2407
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Fax |
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Provider Business Mailing Address
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Address Line | 70 CRABAPPLE RD
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City | WINDSOR
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State | CT
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Zip | 06095-1821
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PCT.008094
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License Number State | CT
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