Provider Demographics
NPI:1194073072
Name:LEUSCHEN, TRACI L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TRACI
Middle Name:L
Last Name:LEUSCHEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:TRACI
Other - Middle Name:L
Other - Last Name:RIZZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-445-0873
Mailing Address - Fax:216-636-5272
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:DD-3
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-0873
Practice Address - Fax:216-636-5272
Is Sole Proprietor?:No
Enumeration Date:2012-08-26
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03331202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist