Provider Demographics
NPI:1285957332
Name:HALEY-BROWN, LEANNE (RPH)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:HALEY-BROWN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 PETTIT ST
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NY
Mailing Address - Zip Code:14172-9696
Mailing Address - Country:US
Mailing Address - Phone:716-751-0140
Mailing Address - Fax:716-751-0167
Practice Address - Street 1:272 PETTIT ST
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NY
Practice Address - Zip Code:14172-9696
Practice Address - Country:US
Practice Address - Phone:716-751-0140
Practice Address - Fax:716-751-0167
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI039392183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist