Provider Demographics
NPI:1558015321
Name:MCCALLAR, LEANN
Entity type:Individual
Prefix:
First Name:LEANN
Middle Name:
Last Name:MCCALLAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 OAKMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3461
Mailing Address - Country:US
Mailing Address - Phone:716-830-1358
Mailing Address - Fax:
Practice Address - Street 1:233 OAKMONT AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3461
Practice Address - Country:US
Practice Address - Phone:716-830-1358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty