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General NPI Number Information
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NPI Number | 1255750071
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Entity Type | Individual
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Provider Name | MYRON FRANK LESH RP
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Gender | Male
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 305 E. RIDGEWOOD AVE.
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City | RIDGEWOOD
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State | NJ
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Zip | 07450
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Country | US
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Telephone | 201-444-4500
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Fax | 201-444-2720
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Provider Business Mailing Address
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Address Line | P.O. BOX 762 305 E. RIDGEWOOD AVE.
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City | RIDGEWOOD
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State | NJ
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Zip | 07450
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Country | US
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Telephone | 201-444-4500
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Fax | 201-444-2720
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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 | 28RIO1401700
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License Number State | NJ
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