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General NPI Number Information
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NPI Number | 1457534489
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Entity Type | Individual
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Provider Name | BABETTE MICHELLE LEBLANC
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Gender | Female
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 4 PLEASANT AVE
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City | TUPPER LAKE
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State | NY
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Zip | 12986-1419
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Country | US
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Telephone | 518-359-3378
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Fax | 518-359-9424
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Provider Business Mailing Address
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Address Line | 563 DEERLAND RD PO BOX 68
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City | LONG LAKE
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State | NY
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Zip | 12847-0068
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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 | 039550
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License Number State | NY
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