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General NPI Number Information
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NPI Number | 1902051972
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Entity Type | Individual
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Provider Name | ANTHONY RUSSELL LEGGIO PHARM D.
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Gender | Male
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 1800 WALT WHITMAN RD STE 170
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City | MELVILLE
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State | NY
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Zip | 11747-3267
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Country | US
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Telephone | 631-370-2009
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Fax |
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Provider Business Mailing Address
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Address Line | 72 BURTON LN
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City | COMMACK
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State | NY
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Zip | 11725-1941
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Country | US
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Telephone | 631-375-1617
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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 | 052639
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License Number State | NY
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